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Official journal of the International Society
Revue officielle de la Societe Internationale
Vol. IX, No 2 December, 2003
Official journal of the International Society for the History of Medicine Revue officielle de la Societe Internationale d'Histoire de la Medecine
Vesalius Acta Internationalia Historiae Medicinae
E D I T O R S - R E D A C T E U R S
A . Le l louch. D . W r i g h t
A S S I S T A N T E D I T O R
R E D A C T E U R A D J O I N T
J. S. G. Blair, OBE, KStJ.
A D D R E S S F O R C O R R E S P O N D E N C E
A D R E S S E
J. S. G. Blair,
The Brae,
143 Glasgow Road,
Perth, PH2 O L X ,
Scotland, Uni ted Kingdom.
G U I D E F O R A U T H O R S S U B M I T T I N G
M A N U S C R I P T S T O A B O V E A D D R E S S .
I M P O R T A N T .
Art ic les are accepted in English or French. They are to
be typewr i t ten in tr ip l icate, w i th double spacing and
wide margins, on one side of A4 paper only. A summary
in both languages and a shor t biographical note should
be given. The maximum length is about 3000 words .
Authors using a w o r d processor (PC preferably) should
send a diskette.
Al l articles must be original. Au tho rs must conf i rm that
wr i t ten material and any i l lustrations are no t subject to
copyright elsewhere. If the copyright of i l lustrations is
not owned by the author, they must be accompanied by
the owner 's permission to reproduce. Au tho rs wi l l be
asked to sign a transfer of copyright. References should
be numbered sequentially in the t e x t and arranged in
numerical o rder at the end. Each reference should
contain names and initials of authors and full t i t le of
paper or work.Journal name should be fo l lowed by year,
vo lume, number, f i rs t and last page of reference.
References to books should include date and place of
publication and of publishers. The names of books and
periodicals should be given in italics or underl ined.
All articles to be sent to the assistant editor.
E D I T O R I A L B O A R D
C O M I T E D E R E D A C T I O N
K. Bergdolt, B. Belicza, C. Burns, A. Diamandopoulos,
G. Ferngren J. Ford, A. Musajo Somma,
R. Olry.Y.V. O 'Ne i l l , J. Pearn, R. Price, A. Segal, M.Thiery,
J-PTricot, S.Weir, G. Zanchin.
J O U R N A L S U B S C R I P T I O N
A B O N N E M E N T A L A R E V U E
2 issues annually - 2 numeros par an.
Annual 50 euros, 50 US $, £35.
Free to ISHM members.
Gra tu i t pour les membres SIHM
I N S T R U C T I O N S A U X AUTEURS.
IMPORTANT.
Les articles sont acceptés en français ou en anglais. Ils
doivent êt re dactylographiés avec un double interl igne,
une marge blanche, des pages numérotées, papier A4 et
envoyés en t ro i s exemplai res. Ils do ivent ê t re
accompagnés d'un résumé dans les deux langues et
d'une not ice biographique de l'auteur. Ils seront soumis
au comi té de lecture avant publ icat ion. Le longueur du
tex te ne devrait pas excéder 3000 mots.
Tous les articles doivent être originaux. Les auteurs
do ivent con f i rme r que ceux-c i , ainsi que leurs
i l lustrations, ne sont pas sujets au copyright. Si les
i l lustrations ne sont pas la propr ié té de l'auteur, elles
do ivent ê t re accompagnées d'une permiss ion de
reproduct ion . Les auteurs devront signer un t ransfert de
copyright. Les auteurs util isant un ord inateur sont priés
d'envoyer une diskette (PC). Les références devront être
numéro tées dans le t e x t e et rangées par o r d r e
numér ique, à la fin de l'article. Chaque référence devra
conteni r les noms et les initiales des auteurs, le t i t re de
l'article ou du travail en entier, ainsi que le nom du
journal qui devra êt re suivi de l'année, du numéro de
volume, des première et dernière pages de la référence.
Les références de livres devront indiquer la date et le
lieu de publication ainsi que le nom des éditeurs. Les
t i t res de livres ou périodiques doivent être indiqués en
italique ou soulignés.
Tous les manuscrits doivent être soumis au rédacteur adjoint.
I
Editorial,Vesalius, IX , 2, 2-3, 2003
A new French Language editor for Vesalius
At a meeting of the Editorial Board of Vesalius in Paris, in June 2003, the appointment of Alain Lellouch as French Language editor was unanimously approved. Alain Lellouch was Associate and then General Secretary of the ISHM from 1996-2002. During his "Secretariat", he instituted a new ISHM multi-lingual (English, French and then Spanish) website (www.bium-univ.paris5.fr/ishm) in January 2001 with BIUM (Inter University Library of Medicine, Paris V), as ISHM's partner.
We are very grateful that he is now giving his experience and knowledge to Vesalius. One of the distinctive features of the journal has been its bilingual nature and Alain's appointment is important in
strengthening this. His responsibilities will also include co-ordinating reports from national delegates (for Vesalius and for the ISHM website) and updating the calendar of international events. His contribution is much appreciated and we look forward to a happy association.
David Wright
Un nouveau rédacteur Vesalius, pour la langue française !
Lors du dernier Comité Vesalius à Paris, en juin 2003, la nomination d'Alain Lellouch comme nouveau rédacteur du journal pour la langue française a été approuvée à l'unanimité. Alain Lellouch a exercé les fonctions de Secrétaire Adjoint puis Général de la SIHM, de 1996 à 2002. Durant cette période, c'est lui qui, à partir de janvier 2001, a mis en place le nouveau site internet (www.bium-univ.paris5.fr/ishm) de la SIHM. Ce site bi puis tri-lingue (Français, Anglais puis Espagnol) a été monté en partenariat avec la BIUM (Bibliothèque Inter-Universitaire de Médecine de Paris V).
Nous sommes très heureux qu'Alain fasse maintenant bénéficier Vesalius de son expérience et de son savoir. L'un des traits les plus caractéristiques de notre journal est son bilinguisme et la nomination d'Alain à ce poste est importante dans la mesure où elle renforce justement le bilinguisme de notre revue. Les responsabilités du nouveau rédacteur inclueront aussi la collection et la coordination des rapports émanant des Délégués Nationaux (pour Vesalius et pour le site internet) ainsi que l'actualisation des manifestations internationales en histoire de la médecine. Cette contribution est très appréciée et nous attendons beaucoup de cette heureuse collaboration.
David Wright
2
Editorial.Vesalius, IX , 2, 2-3, 2003
Editorial
Dr Philippe Albou : Secretary General of ISHM
3
Vive la mondialisation de la culture !
Autant la mondialisation de l'économie peut poser légitimement des questions sur les arrière-pensées des uns et des autres, notamment entre les pays riches et les pays pauvres de notre planète, autant l'accès mondialisé à la culture ne se discute pas. Avec l'arrivée et le développement d'Internet, un mouvement vers la diffusion des savoirs est désormais en marche et ceci, de manière forte, continue et incontournable. Depuis leur domicile ou bien, sur leur lieu de travail, ou dans les cyber-cafés qui se développent partout dans le monde, y compris dans les pays à faible développement économique, un nouveau monde est en train de naître sous nos yeux, dont nous n'avons même pas encore une conscience claire.
L'histoire de la médecine est en train de suivre ce mouvement mondial. Il est désormais possible de consulter en ligne un nombre incalculable de documents et, souvent en accès libre, comme en France sur le site de la BIUM (voir l'article dans ce numéro) ou sur le site de la Bibliothèque nationale (http://gallica.bnf.fr/ ). De nombreux documents sont également disponibles en langue anglaise, avec notamment la mise en ligne récente des 240,000 articles parus dans le Lancet depuis 1823 (http://www.info.sciencedirect.com/backfiles/collections/lancet/index.shtml).
Notre société se doit de tenir compte de cette nouvelle donne extrêmement positive. Parallèlement à notre revue Vesalius dont la qualité doit, bien entendu, être défendue car il en va de la reconnaissance scientifique de notre société, le développement de notre site Internet (http://www.bium.univ-paris5.fr/ishm/) et de notre forum de discussion (inscription sur [email protected]) seront amenés à se développer de plus en plus, dans les mois et les années à venir, dans le sens de ce mouvement mondial, à la fois souhaitable et inéluctable.
Dr Philippe Albou : Secrétaire Général de la SIHM
Cultural globalisation advances
As long as economic globalisation raises serious questions about its hidden motives, particularly in the relationships between the rich and the poor countries of our world, cultural globalisation will not be discussed.With the creation and subsequent development of the internet, a movemement fostering diffusion of knowledge has been unleashed which continues with such strong force as to be unstoppable. From the home, the work place or the cyber cafes which have appeared everywhere, even in less well developed countries, a new world is being created before our eyes, though we don't yet see it very clearly.
The History of Medicine is following this global movement. It is now possible to consult on line, often with free access, an enormous number of documents, in France on the BIUM website (see the article in this edition ofVesalius) or on the website of the French Bibliotheque nationale (http://gallica.bnf.fr./). Many documents are also obtainable in English, particularly with the recent availability on line of 240,000 articles which have appeared in the Lancet since 1823 (http://www.info.sciencedirect.com/backfiles/collections/lancet/index.shtml).
Our Society must take this new medium into account very seriously. Alongside our journal Vesalius, the quality of which must be maintained, as with it goes scientific recognition of the Society, our internet site (http://www.bium.univ-paris5.fr/ishm/) and our discussion forum (at [email protected]) will be encouraged to develop more and more in the months and years ahead, towards that globalisation which seems appropriate and irresistible.
L e site I n t e r n e t d e l a B i b l i o t h è q u e In te r -un ivers i ta i re d e Médec ine ,Vesa l ius , I X , 2 , 4 - 5 , 2003
Le site Internet de la Bibliothèque Inter-universitaire de Médecine
(BIUM) de Paris http://www.bium.univ-paris5.fr/
Philippe ALBOU et Christian REGNIER
I n t r o d u c t i o n
L'Histoire de la Médecine bénéficie actuel lement d'une
immense bouffée d'oxygène avec l'accès, par Internet, à
un nombre phénoménal d ' informat ions de toutes sortes
et de toutes provenances. Le site de la BIUM de Paris
représente au sein même de cette «révolut ion» la
référence désormais incontournable pour ce qui est de
l 'histoire de la médecine sur l ' Internet francophone.Voici
succinctement les possibilités offertes sur ce site aux
internautes historiens de la médecine et ceci en accès
ent ièrement libre :
I . Les cata logues de la B I U M en l igne :
- Le fond ancien (fiches manuscrites photographiées)
où l'on peut re t rouver les références des
338.000 ouvrages disponibles à la BIUM de
1477 à 1952, mais aussi de 3.500 revues
paraissant avant 1920, et de 800 manuscrits;
- Références de 150 revues modernes, t ra i tant
d'histoire de la médecine;
- Tous les ouvrages t ra i t an t d 'h is to i re de la
médecine entrés à la BIUM depuis 2001, par
t r imest re ;
- Rappelons que dans la part ie «générale» du site
beaucoup d'autres ouvrages sont référencés (avec
une base de recherche électronique) dont les
100.000 thèses de médecine et 20.000 thèses
dentaires soutenues en France depuis 1985.
L a co l lec t ion M e d i c @
Cet te col lect ion se propose de rééditer, sous une
fo rme électronique et accessible gratui tement, des
documents anciens appartenant au fonds de la
4
Résumé L'histoire de la médecine connaît actuellement une très grande diffusion grâce au développement d'Internet, avec une grande ressource d'informations de toutes sortes. Le site de la BIUM de Paris est au coeur de cette évolution pour l'histoire de la médecine. Depuis sa restructuration, en avril 2003, ce site est devenu encore pus convivial et plus performant. Notre société peut être fière d'être hébergée sur ce site depuis 2000. Cet article récapitule brièvement les possibilités offertes par le site de la BIUM en accès libre et gratuit. Celles-ci incluent les catalogues de la BIUM, la collection Medic@ (qui regroupe de nombreux documents et livres médicaux depuis Hippocrate), ainsi que les textes fondateurs des diverse spécialités médicales, des liens avec onze sociétés d'histoire de la médecine (dont notre SIHM et la société française de l'histoire de la médecine) ainsi que de nombreux liens vers d'autres sites d'histoire de la médecine en France et dans le monde.
Summary History of medicine has received a huge boost from access via the Internet to an enormous collection of information of all varieties.The BIUM site in Paris is at the heart of this revolution for the history of medicine.The new site became active in April 2003 and has since become even easier to use and more comprehensive. Our society can be proud of the fact that it has been on line since 2000. This article briefly summarises the possibilities that the BIUM site offers, completely without charge.These include the BIUM catalogues, the Medic@ collection of documents and books from Hippocrates onwards, including those which relate to the founding of the various medical specialties, links to I I history of medicine sites in France, including the ISHM and the French Society of the History of Medicine and many other facilities including links to museums and various history of medicine sites in France and elsewhere.
Le site Internet de la Bibliothèque Inter-universitaire de Médecine,Vesalius, IX , 2,4-5,2003
BIUM : ouvrages, articles, manuscrits. Cette collection, qui se développpe depuis octobre 2000, comprenait en mars 2003 près de 1.500 documents correspondant à plus de 140.000 pages. Les documents numérisés sont généralement accompagnés d'une introduction rédigée par un spécialiste de la discipline. Elle comprend trois séries:
- Corpus des médecins de l'Antiquité, avec l'ensemble des éditions majeures des auteurs anciens (Hippocrate, Galien, Oribase...) depuis la Renaissance jusqu'au 19e siècle;
- Histoire des spécialités médicales, qui rassemble les textes fondateurs de quelques disciplines (ophtalmologie, odontologie, paléopathologie, oto-rhino-laryngologie, alchimie médicale, etc.);
- Varia, où sont édités des documents sur des thématiques diverses : les thèses importantes du 19e siècle (plus de 150 thèses sont actuellement en ligne), les manuscrits et publications de Xavier Bichat, un «Dictionnaire des maladies éponymiques et des observations princeps», etc.
ce site comprend de nombreux textes et documents sur l'histoire de l'Académie, ainsi que le Catalogue du fonds ancien.
4. Autres éditions électroniques : - Collection Asclépiades: thèses récentes dans le
domaine de l'Histoire de la médecine, en texte intégral (actuellement six thèses de ce type sont en ligne);
- Les actes de la Société Française d'histoire de l'Art dentaire: intégralité de ces comptes rendus depuis 1996 (avec de très belles illustrations);
- Bulletin de médecine ancienne (site bilingue): annuaire international des chercheurs dans ce domaine, base de données bibliographiques et annonces de congrès concernant la médecine de l'Antiquité et du Moyen-âge;
- Bulletin de médecine des Temps modernes: base de données bibliographiques et annonces de congrès concernant la médecine de la Renaissance à la Révolution.
3. Hébergement de I I sites en relation avec l'histoire de la médecine, parmi lesquels : - Le site de notre Société Internationale
d'Histoire de la Médecine (trilingue), qui est par ailleurs en pleine évolution avec, durant l'année 2003, la mise en ligne d'une base de données et I' accès aux résumés des articles parus dans Vesalius, ainsi que les résumés des communications publiées dans les actes des congrès de la SIHM, en commençant par ceux de Tunis (1998) et de Galveston (2000), c'est-à-dire au total d'environ 250 résumés dans chaque langue;
- Le site de la Société Française d'Histoire de la Médecine (qui est actuellement en phase de réactualisation);
- Le site de la Société Française d'histoire de l'Art dentaire, avec notamment une «Petite histoire de l'Art dentaire 1900-1950» et une «Histoire de l'aménagement opératoire du cabinet dentaire 1700-1960» (en 24 chapitres avec 700 documents iconographiques);
- Le site du Club de l'Histoire de l'Anesthésie Réanimation, avec de nombreux textes et une banque d'images;
- Le site de la Société française d'histoire de la Dermatologie, avec de nombreux textes, une banque d'images et une importante bibliographie;
- Le site de l'Académie nationale de Chirurgie:
5. Banques d'images, de portraits et de biographies : - 3.000 portraits et images extraits d'ouvrages
anciens et de la collection iconographique de la BIUM;
- 10.000 noms et références bio-bibliographiques concernant des médecins ou des scientifiques anciens, avec le cas échéant un lien avec les portraits.
6. Des expositions virtuelles : Quatre expositions fort bien illustrées et commentées sont actuellement en ligne: - 100 frontispices de livres de médecine du 16e au
19e siècle; - L'Herbier de Paolo Boccone; - Les Gueules Cassées; - Le Voyage en Italie du Docteur Cloquet.
7. Liens Internet en rapport avec l'histoire de la médecine : Dans cette partie, un grand nombre de liens, réactualisés et vérifiés régulièrement, sont proposés avec notamment: - Lien avec les principales bibliothèques françaises
ayant un fond important en histoire de la médecine;
- Liens avec le site Internet de 14 musées français d'histoire de la médecine.
5
T h e s o o t e r k i n dissected,Vesal ius, I X , 2 , 6 -14 , 2 0 0 3
In 1724 John Maubray MD (1700-1732), a then l i tt le
known London man-midwife and teacher of midwi fery
published The Female Physician (Figure I) , a book on the
practice of midwifery, based on the non- instrumental
system of the recently deceased Hendr ik van Deventer
(1651-1724) . The aspect o f Maubray's w o r k tha t
at t racted most at tent ion was a shor t passage in which
he claimed to have delivered a Dutch woman of a
strange animal that he called de suyger:
That these BIRTHS in those Parts, are often
attended and accompany'd w i t h a Monstrous l i t t le
Animal, the likest of any thing in Shape and Size to a
M O O D I W A R P ; having a hooked snout, fiery sparkling
Eyes,a long round Neck, and an acuminated ShortTail,
of an ext raord inary Agility of FEET. At f i rst sight of
the Wor ld 's Light, it commonly Yells and Shrieks
fearfully; and seeking fo r a lurking Hole, runs up and
down like a l i t t le Daemon, which indeed I t o o k it for,
the f irst t ime I saw it, and that fo r none of the bet ter
s o r t -
no t many Years ago, in coming f rom Germany over
East and Wes t Friesland, to Holland, I t o o k passage in
the ord inary Fare-Vessel, f r om the Ci ty of Harlingen
for Amsterdam.. .
Amongst the bet ter Sor t of the Passengers, w h o
posses'd the Cabine, there happen'd to be a Woman
big with Child, of a very creditable Aspect, who...was
taken all at once, aboard the Ship, w i th a sudden and
surprising LABOUR: upon which occasion, in shor t
I immediately lent her a helping Hand, and upon the
Membran's giving way, this forement ioned A N I M A L
made its wonder fu l Egress; fill ing my Ears w i th
dismal SHRIEKS, and my Mind w i t h greater
C O N S T E R N A T I O N . . .
I heard some of ou r Accidental Company call it de
Suyger, as they wen t about to kill it: upon which I
immediately laid [del ivered] the Woman of a pret ty
plump GIRL; who , notwi thstanding all this, had no
Deformity upon it, save only many dark, livid SPOTS
all over its Body...
6
Résumé En 1724, la description de John Maubray donnée du sooterkin fut tournée en ridicule. Le sooterkin était cet étrange animal auquel les mères humaines donnaient naissance en même temps qu'un enfant normal. Selon un commentateur, de telles créatures ne pouvaient s' expliquer par la génération spontanée. La littérature européenne du XVIIe siècle qui traite des naissances monstrueuses mentionne l'existence de plusieurs progénitures non-humaines, nées de mères humaines. Ces naissances non-humaines laissent entrevoir les premières théories modernes du développement foetal. Les naissances de sooterkin étaient différentes de produits de conception tels que les môles hydatidiformes, censés eux provenir de la semence humaine. Cette théorie explicative émergea au début du XVIIe siècle : le philosophe naturaliste, Fortunio Liceti, émit l'idée d'une semence humaine subissant une dégénéresence et pouvant produire un foetus. Ce dernier ressemblait à un animal ou pouvait être de nature animale. Le concept s'étendit ensuite au foetus humain qu'on croyait capable de dégénérer, sous l'effet de stimulations externes telles que les empreintes maternelles. La théorie de la dégénéresence séminale explique l'intérêt des auteurs du XVIIe siècle pour rapporter des cas d'animaux, nés de mères humaines. Le phénomène servit de preuve pour expliquer certaines théories embryologiques complexes. Ces théories postulent un développement foetal animal ou humain censé procéder de façon semblable. Les anomalies surviennent dès que le produit de conception suit une autre voie de développement.
Summary John Maubray's description of the sooterkin, a strange animal born to human mothers usually along with a normal
infant, provoked ridicule when it was published in 1724. It seemed to one commentator that such creatures could only be explained by spontaneous generation. Examination of the seventeenth-century European literature on monstrous births provides many accounts of non-human offspring born to human mothers.These provide an insight into early modern theories of foetal development. Sooterkin births were distinct from other'false conceptions' such as moles, but like moles they were believed to arise from human semen. This theory arose at the beginning of the seventeenth century, when the natural philosopher Fortunio Liceti proposed that human semen could degenerate and give rise to a foetus that either resembled an animal or truly was animal in nature.This concept was later extended to the human foetus itself, which it was thought could degenerate in response to external stimuli such as maternal impressions.The theory of seminal degeneration offers an explanation for the increased interest in reports of animals born to human mothers that occurred in the seventeenth century. It is also evidence of sophisticated embryological ideas: foetal development in animals and humans was thought to proceed along similar lines, and abnormalities occurred when the conceptus followed an alternative developmental pathway.
The sooterk in dissected, Vesalius, IX , 2, 6-14, 2003
AFTERWARDS I had occasion to talk w i th some of
the most learned Men, of the several famous
Universities in these Provinces upon this Head; w h o
ingenuously to ld me, that it was so c o m m o n a
Thing, among the sea-faring, and meaner so r t of
People, that scarce O N E of these Women in Three
escaped this kind of strange BIRTH; which my o w n
small Practice among t hem af terwards also
con f i rmed : Insomuch, that I always as much
expected the Thing de Suyger, as the C H I L D it self:
And besides the W o m e n in like manner, make a
respective suitable Preparation, to receive it warmly,
and t h r o w it into the Fire; holding Sheets before the
Chimney, that it may no t get off; as it always
endeavours to save it self, by gett ing into some dark
Hole or Corner.They proper ly call it de Suyger, which
is (in our Language) the SUCKER, because, like a
Leech, it sucks up the INFANT'S Blood and Aliment'
Although Maubray did no t use the w o r d sooterkin in
his account of de suyger, he was describing something
that was already part of the English language. In 1654,
John Cleveland (1613-1658) had w r i t t en , ' The re goes a
repor t o f the Holland W o m e n , that together w i th thei r
Chi ldren, they are delivered of a Sooterk in, no t unlike to
a Rat, which some imagine to be the Offspring of the
Stoves.'2 In her Midwives Book, published in 1671,Jane
Sharp included sooterkins along w i th o ther animals
generated in the w o m b :
[a]s fo r monsters of all sorts to be fo rmed in the
w o m b all nations can bring some examples;Worms,
Toades, Mice, Serpents, Go rdon ius saith, are
common in Lumbardy, and so are those they call
Soole kints in the Low Count r ies , which are
certainly caused by the heat of the i r stoves and
menstrual b lood to w o r k upon in w o m e n that have
had company w i th men; and there are sometimes
alive w i th the infant, and when the Chi ld is brought
f o r t h these stay behind, and the w o m a n is
sometimes thought to be w i th Chi ld again; as I knew
one there my self, which was after her chi ld-bir th
delivered of t w o like Serpents, and both run away
into the Burg wall as the woman supposed, but it
was at least three months after she was delivered of
a Chi ld, and they came fo r th w i t h o u t any loss of
b lood, for there was no after burden.'3
Shortly after it was published, Maubray's claim to have
delivered sooterkins was ridiculed by the surgeon James
Douglas (1675-1742) in a pamphle t en t i t led The
Sooterkin Dissected,4 w r i t t en under the pseudonym of
Philalethes or 'a lover of t r u t h and learning.' Dutch
mothers , Douglas observed, called the i r ch i ld ren
'sooterkints, ' or sweet chi ldren, but there was no
creature called de Suyger, and he offered readers a guinea
fo r every sooterk in brought f r om Hol land.This so r t o f
sat ire made an impress ion, and Maubray became
popularly known as ' the sooterk in doctor.'5 Maubray's
account of the sooterk in may have been an intent ional,
and indeed successful, a t tempt to obtain publicity fo r
The Female Physician by including some remarkable
material (he also ment ioned the s to ry of Countess
Margaret of Henneberg 's 365 ch i ldren and later
attended the b i r th chamber of the most celebrated of
e ighteenth-century England's producers of non-human
offspring, the ' rabbi t -breeder ' Mary Toft, Figure 2).6
Whateve r Maubray's motives were , Douglas's response
to his account links repor ts of non-human animals
produced in the w o m b w i t h the spontaneous generat ion
controversy. Examination of the l i terature on animals
born to human mothers in the seventeenth century
shows that they were usually considered to be types of
false conceptions rather than spontaneous generations.
This suggests a m o r e comp lex v iew of foetal
development than has sometimes been supposed.
The extensive l i terature on monstrous births in
books, journals and broadsides of the sixteenth and
seventeenth centur ies, which was larger than that
dealing w i th 'convent ional ' ch i ldbi r th, was p rompted not
only by the hunger fo r curiosit ies shown by both
medical and lay readers, but also by the relevance of
mons t rous b i r ths to ongoing debates on natural
philosophical problems such as foetal development and
heredity, as wel l as to theological concepts such as divine
in tervent ion. Sooterkins were not , str ict ly speaking,
mons t rous b i r ths because, as Douglas w r o t e , the
sooterk in was a prodigy, 'contrary to the who le Course
of Nature, ' rather than a monster as Maubray had
perhaps carelessly t e rmed it. This seemingly pedantic
dist inct ion was a crucial one in the early modern
l i terature:
A monster is anything that appears outside the
usual course and o rde r of nature, such as a child
w i th t w o heads, or which has three or more arms
or o t h e r super f luous members , mut i la ted or
maimed.
A prodigy is that which goes total ly against nature,
such as if a woman gives b i r th to a beast, whether
four - footed, aquatic, flying, repti l ian, or of some
o ther kind.7
One difference was that monsters were mal formed
human offspring remarkable principally fo r thei r rar i ty
whereas prodig ies, wh ich w e r e n o t necessarily
mal formed, were no t human. Unlike monstrous bir ths,
7
T h e s o o t e r k i n dissected.Vesal ius, I X , 2 , 6 - 1 4 , 2 0 0 3
sooterkins were regarded as non-human and midwives
were expected to kill them.8
Douglas's a rgument against the ex is tence of
sooterkins had t w o main strands.The f irst was that no
one had ever seen one. In itself this was a weak
argument not only because absence of evidence is not
evidence of absence but also because, despite his having
'lately seen a Book of Ruyschius, called, 'Tractatio
Anatomica de Musculo in fundo uteri, page 16 where he
confesses, that after sixty t w o Years Practice in dissecting
diverse Bodies of W o m e n in Holland, he never saw this
Animal,' Douglas had to admit that there were many
published descript ions of sooterk ins, some of which he
quoted, w i t h the suggestion that they were intended to
be unders tood only in a 'mora l ' rather than a 'natural '
sense. His second argument was that spontaneous (or
equivocal) generat ion did no t occur : ' I f there is any such
thing as equivocal generat ion; W h y no t a Bird or a Man
produced this way sometimes? W h y no new species n o w
and then? There must certainly be a pre-existent
An ima lcu le . . . . No Animal is bred of Corruption whatever
its Nidus!9
S p o n t a n e o u s g e n e r a t i o n
The early modern per iod saw a restr ic t ion in the
kinds of animals thought to be produced by spontaneous
generat ion. A lmos t no-one supposed that Men were still
f o r m e d in this way, though spontaneous human
generat ion was invoked by some to explain the origin of
mankind after the Biblical f lood:
Avicenna [Ibn Sina 981-1037] , in that w o r k of his
which he made of deluges and flouds; holds, that
after the great f louds that d rowned the Earth, there
was no mans seed; but then, man, and all living
Creatures else, were generated of ro t ten carcasses,
only by the ver tue of the Sun: and therefore he
supposeth, that the w o m b , and such needful places
framed by nature, fo r the bet ter fashioning of the
infant, are no t needful to the procreat ion of man.
He proves his assertion by this, that mice, which
arise of putrefact ion, do couple together, and beget
s tore of young; yea, and serpents are generated
chiefly [i.e., most common ly ] of womans hair...10
Al though Douglas represented the idea of a man or a
b i rd being p roduced spontaneously as being self
evidently absurd, some quite complex animals such as
mice were thought to arise ei ther f rom seed of thei r
own kind or f rom putrefact ion. I t is noticeable that the
animals mos t o f ten pu t f o r w a r d as arising by
spontaneous generat ion w e r e e i ther ve rm in o r
dangerous and unpleasant pests such as flies, snakes,
mice and wo rms : creatures perhaps thought f i t to be
generated f r om cor rup t ion . The rodent- l ike sooterk in
was certainly the type of creature that might arise in this
way: ' I t commeth also to passe, that by the cor rupt ion ,
that some hurtful l living creatures, or shapes of living
creatures are ingendered in the Matr ix w i th chi ldren.. . '1
Since the classical per iod, menstrual b lood had been
commonly regarded as deleterious to life (the presence
of a menstruat ing woman was enough to make seeds
and f ru i t t rees steri le and wine tu rn sour)12 and
menstruat ion was thought to be beneficial to women as
i t r id the i r b lood of impur i t ies . I t fo l lowed that
'suppression of the f lowers ' was harmful, and measures
such as cupping, bleeding and purging were employed if
menstruat ion failed to occur.13 In terms of humoral
t heo ry w o m e n menstruated because they were cold and
humid whereas men were w a r m and dry. Moisture and
heat w e r e bo th necessary fo r generat ion,1 4 and
therefore the best t ime to conceive was just before or
after menstruat ion. On the o ther hand, conception
dur ing menst rua t ion was f raught w i t h prob lems. I !
Moisture when combined w i th the heat of the male
semen was the basis of putrefact ion, because moist
humours were:
. . .excrementat ions and also alimentations, by which
the least defect of Heat is easily tu rned into
putrefact ion. . .whence it is that foul Bodies,Trees
cut down at Full Moon , being full of thei r sap, and
Fruits gather'd before thei r maturity, very easily
co r rup t . . . "
Sooterkins or o ther animals were produced during
pregnancy along w i th the foetus because at this t ime
menstruat ion ceased and menstrual b lood accumulated
in the w o m b : as Or to l f f von Bayerland's Frauenbuchlein
( l i t t le book of women) put it, ' f i l th may gather in the lying
in woman.'17 The w o m b could thus prove fert i le in an
undesired way:
Ne i ther is it hard to generate Toades of womens
putr i f ied f lowers; for women do breed this kind of
cat te l , toge ther w i t h the i r chi ldren, as Celius
Aurelianus and Platearius call them, frogs, toads,
lizards, and such like: and the w o m e n of Salerium, in
t imes past, were w o n t to use the juice of Parsley
and Leeks, at the beginning of thei r concept ion, and
especially about the t ime of the i r quickening,
thereby to destroy this kind of vermin w i th them.'8
The theo ry that sooterkins were generated f rom
cor rup t ion in the w o m b could explain why they were
unique to humans - o ther animals produced monstrous
bir ths but never sooterk ins - as humans were the only
animal that enjoyed the 'advantage' of menstruat ion: 'as
8
T h e s o o t e r k i n dissected,Vesal ius, I X , 2 , 6 - 1 4 , 2003
beneficial to them as it is extraordinary."9 However,
unlike creatures produced by spontaneous generat ion,
sooterkins were fo rmed f rom human semen, and in this
respect they resembled o t h e r so-cal led 'false'
conceptions.
False C o n c e p t i o n s
Several histor ians have l ikened soo te rk ins to
hydatidiform moles. Marland for example states that the
vlyger (an alternative f o rm of suyger): 'has been defined
as a lump of meat that was driven f rom the body of the
mother in the same way as a miscarriage. It wou ld
appear to be similar to the "mole" described in Aristotle's
Works...'20 Gelis cons idered soo te rk ins to be a
misinterpretat ion of hydatidi form moles: ' [ the mole's]
irregular shape gave rise to the weirdest interpretat ions
on behalf of the women w h o had witnessed the event.
Some would have "seen" the woman give b i r th to a dead
animal, rat, mole, or to r to ise ; others saw a living four-
footed animal,armed w i th claws and hooked nails...'21 In
my view there are several problems w i th this theory.
Firstly, hydatidi form mole, known simply as mola, a mass,
was well known in the seventeenth century. The man-
midwife Guil laume Mauquest de la Mo t te (1655-1737)
described it as 'a false Concept ion ' and 'a Shapeless
mass' and one of his patients, t w o months pregnant,
diagnosed her o w n molar pregnancy, a diagnosis
subsequently conf i rmed at delivery.22 Secondly, the
interpretat ions proposed by Gelis are improbable - a
mole looks nothing like any of them. W h e n molar
pregnancies were in terpreted as living things it was as a
'palpitating marine zoophyte'23 or Countess Margaret's
365 chi ldren, each, presumably, in its own gestational sac.
Thirdly, the sooterk in was often said to emerge after the
bir th of a baby, a kind of monstrous af terb i r th , whereas
one of the characteristics of a complete hydat idi form
mole is that there is no associated foetus.24
Moles and o the r 'false concept ions' we re never
known to be produced w i t h o u t copulat ion: the strange
bodies ('corps estranges') passed on occasion by virgins
turned ou t on close inspection to be merely 'Clods of
Blood coagulated'.25
Moles are ordinari ly engendered, when ei ther the
Man's or Woman's Seed or both together, are weak
or cor rup ted , the W o m b not labouring fo r a t rue
Concept ion, but by the help of the Spirits by which
the Seed ought to be replenished: but so much the
easier, as the small quant i ty found in it is
extinguished, as it were choaked or d rowned by
abundance of the gross and cor rup ted menstruous
b lood, which sometimes f lows th i ther soon after
Concept ion, and gives no t leisure to Nature to
perfect what she hath w i t h great Pains begun, and
so t roubl ing its w o r k , bringing th i ther Confusion
and Disorder, there is made of the Seeds and Blood
a meer Chaos, call'd a Mole, not usually ingendered
but in the W o m b of a W o m a n , and never or very
rarely found in the o ther Animals, because they have
no menstrous [sic] Blood as she hath.26
Such false concept ions w e r e no t examples of
spontaneous generat ion - they did not arise f rom
c o r r u p t i o n alone but requ i red semen, however
defective:
'Averrois and Paulus Aegineta doe declare that this
deformed lump of flesh is ingendered of the
weaknesse and debil i ty of bo th the seedes,that is to
say, of the mans and womans, or else of the
co r rup t ion of good seedes, which happeneth about
the f i rst t ime of concept ion. But others doe say, that
it is engendered of the abundance of the f lowers or
Terms, because through the great heat of the Matr ix
they are sometimes congealed and c lot ted together,
and brought into a misshapen masse or lump of
flesh; but they which doe more narrowly pry and
search into the Natures of things, doe at t r ibute this
to the more copious and abundant seed of the
w o m a n , especially in those w o m e n w h o are
somewhat more lascivious than others are, which
conceiving l i t t le seed f r om the i r husbands, dry by
nature, by the desire of the Matr ix [one funct ion of
which was to 'at t ract ' the seed], doe st i r re up
copious seed of the i r owne, which augmented w i th
the f lowers, by the heat of the Matr ix , is congealed
together, and by the defect and want of mans seed,
the proper worke-man and contr iver of it, do th
g row together in such a lump: For nothing can be
ingendered w i t h o u t the seed of man; as neither any
can be ingendered of the seed of w o m e n only.. . '27
False concept ions occur red when human seed was
' co r rup ted ' e i ther of itself or through its environment:
'Moles always proceed f r om some false Concept ions,
which cont inuing in the W o m b , increase gradually by the
Blood that f lows to t h e m . . . W o m e n expel these false-
conceptions sooner or later... '28 Unlike sooterkins,
moles had no definite shape: T h e Mole is nothing but a
fleshy substance, w i t h o u t Bones, Joints, or Dist inct ion of
Members ; w i t h o u t Form or Figure, regulated and
determined; engendered against Nature in the W o m b ,
after Copulat ion, ou t of the cor rup ted seed of both Man
and Woman.'29 They also had n o ' t r u e life.'30 The sooterk in
was neither shapeless nor lifeless, but an animal w i th a
distinct, if unusual, f o r m , as Maubray described.
9
The sooterkin dissected, Vesalius, IX , 2,6-14, 2003
Degeneration of the seed Menstrual blood, though inimical to most living things,
was a substrate in which, through corruption, spontaneous generation might occur - Jan Baptista van Helmont used menstrual blood in one of his recipes for spontaneous generation of mice31 - but not all creatures thought to be produced from corruption were formed spontaneously. According to Aristotle's Problems:
anything else which is produced from the semen, as for instance, a worm, or the so-called monstrosities, when there is corruption in the womb, are not to be reckoned as offspring. In a word, anything which is produced from corruption is no longer produced from that which is our own but from that which is alien to us, like that which is generated from excretions such as ordure.32
There is an assumption here that creatures that arose 'from corruption' were nevertheless produced from semen. The admixture of the 'semen' (male and female) with menstrual blood exerted a corrupting influence on the foetus:
Because a child conceived during the menstrual flow takes its nourishment and growth - being in its mother's womb — from blood that is contaminated, dirty, and corrupt, which having established its infection in the course of time, manifests itself and causes its malignancy to appear33
In his book De Monstrorum, first published in 1616 (Figure 3), Fortunio Liceti (1577-1647)34 proposed that degeneration of the semen was a cause for failure of proper foetal development. Liceti advanced an Aristotelian view that monsters were slips of nature rather than part of a divinely-ordered plan and so reestablished the classical concept of monstrous births as mistakes rather than acts of God. A large part of the literature on monstrous births concerned human offspring that resembled animals and Liceti discussed several theories to account for these. Many he attributed to accidental resemblance: the features of abnormal children reminded observers of animals.35 In other cases, he proposed that the semen could degenerate (degenerare) and that this resulted in the foetus developing as if it were an animal: 'In this way, at any time, a woman, without committing adultery or other lewdness, can give birth to a monster whose limbs resemble those of animals of various kinds.'36
'[i]f, therefore, the male semen in the female uterus were to degenerate from its original nature through whatever cause, its vital principle becomes
transformed to another kind; if the whole of the semen were fully changed in this way, whole creatures of diverse kinds are formed; not monsters, but like monsters...'37
In the early modern period there was no concept of the passage of the foetus through progressive developmental stages. The foetus was 'concocted' from the mixed semen and the time taken for this to occur was in practice even less well defined than Aristotle's forty days for the male and four months for the female (after which time maternal impressions could no longer occur).38 Even at six months gestation, it was supposed that a baby could still degenerate (degenere) into a monkey.39 This degeneration was caused not only by the influence of menstrual blood; other stimuli such as maternal impressions could radically change not only the shape of a foetus but also its nature: '[m]any apprehensions seize on the pregnant woman and the foetus changes its whole shape, indeed, it changes its nature, from human to that of a beast...'40 The concept of seminal and foetal degeneration assumed that human development was based on that of other animals. Implicitly, the human foetus was thought to contain within it the nature of' lower' animals.
Accounts of women who gave birth to animal offspring did not originate in the seventeenth century but appear to have come to greater prominence. At the same time, erosion of the once absolute theologically based distinction between humans and animals led to increasing ambiguity about the status of humankind.41
The sooterkin's unpleasant and verminous appearance may have reflected 'a new fear about the status of humanity,'42 that found expression in anxieties over the possibility that human semen and perhaps even the human foetus had the potential to degenerate into a non-human animal.The work of Liceti led to a return to prominence of the Aristotelian view that birth defects were errors of nature, formed when nature does not reach its goal. False conceptions such as moles and sooterkins were conceptually similar in this respect -both arose if the normal process of development failed. The formless mole was, as Aristotle had proposed, the result of failure of the semen to 'concoct.'The concepts of seminal and foetal degeneration reflected an increasingly sophisticated view of developmental processes as hierarchical. In this light the theory that humans could give birth to animals represents not simple credulity but theoretical recognition that the conceptus can follow alternative developmental pathways that are in part environmentally determined.43
10
T h e s o o t e r k i n dissected,Vesal ius, I X , 2 , 6 - 1 4 , 2003
References and N o t e s
1 John Maubray, The female physician, containing all the
diseases incident to that sex...To which is added, the
whole art of new improv'd midwifery.. .together with the
diet and regimen of both the mother and child, London,
J.Hol land, 1724, p. 373.
2 John Cleveland, A Character of a Diurnal-Maker,
London, 1654.
3 Jane Sharp, The Midwives Book. Or the whole ART of
Midwifry discovered. London, Simon Miller, 1671, p.
I I I . O the r examples o f w o m e n giving b i r th t o
animals are to be found in; Ralph Josselin (ed. E.
Hockliffe), The Diary of the Rev. Ralph Josselin, 1616-
1683, London, Camden Society, 1908, p. 32 and in the
ballads The Wonder of Wonders, or, the strange Birth in
Hampshire and True Wonders, and strange news from
Rumsey in Hampshire..., bo th c.1675, repr inted in
H.E. Rollins, The Pack of Autolycus; or, strange and
terrible news of ghosts, apparitions, monstrous births,
showers of wheat, judgments of God, and other
prodigious and fearful happenings as told in broadside
ballads of the years, 1624-1693, Cambridge, MA,
Harvard University Press, 1927, pp, 188-9, 191-4.
O lder accounts of sooterkin- l ike creatures include
Caspar Peucer, Commentarius de praecipuis
divinationum generibus..., W i t t enbe rg , 1553, p. 326
and Stephen Batman, The Doome Warning All Men to
the Judgement..., 1581, London, Ralphe Nubery, pp.
363,412.
4 'Philalethes' or A Lover of Truth and Learning, The
Sooterkin Dissected. In a letter to John Maubray, M.D.
wherein it is clearly prov'd, I. That there never was such
an Animal in theWorld. Il.That God never made it. Ill.That
the Devil cannot make it. IV. That it is Impudence to
assert it. V That it is Stupidity to believe it. VI. That it is a
mere Fiction of his own Brain.VH.That it is contrary to the
Opinion of the most learned Physicians and Philosophers
in our Days, who maintain the Truth of Univocal
Generation, London, A. Moore , 1726.
5 By the late seventeenth century, sooterkin had
become a humorous t e r m fo r an abor t ive or
misconceived enterpr ise.The earliest example of this
usage that I have been able to locate is in Alexander
Brome's (1620-1666) satirical poem Bumm-foder,
published in 1660. The O x f o r d English Dic t ionary
gives fu r ther examples f rom Samuel Butler and
Jonathan Swift.
6 For recent accounts of these cases see Jan Bondeson
and Ar ie Molenkamp, 'The Countess Margaret of
Henneberg and her 365 chi ldren' Journal of the Royal
Society of Medicine 1996, vol. 89, pp. 711-6 and Jan
Bondeson, A Cabinet of Medical Curiosities, London,
I.B.Tauris, 1997, pp. 122-43.
7 'Mons t rum est omne id, quod praeter cursum &
ord inem Naturae apparet;Velut infans biceps, vel qui
habet t r ia aut p lura brachia seu alia membra
superflua muti la vel manca. Prodigiorum est, quod
prorsus cont ra naturam venit, velut si mulier pariar
b ru tum, sive sit quadrupes, aquatile, volati le, rept i le,
sive prodigiosum aliud': Francois Bouchard, 'Infante
monst roso Lugduni in viam publicam die V. Mart i i A.
M D C L X X I . Exposito ' Miscellanea Curiosa 1672, vol . 3,
pp. 14-16.
8 For contrast ing examples of the humane t reatment
of human monstrous births in the popular l i terature
of Elizabethan England see:A.W. Bates, 'Birth defects
described in Elizabethan ballads' Journal of the Royal
Society of Medicine 2000, vol . 93, pp. 202-7.
9 Philalethes, op. cit., pp. I 1, 14, 24.
10 Giovanni Battista della Porta, Natural Magick...in
twenty bookes, London, fo r Thomas Young and Samuel
Speed, 1658, book 2, p. 27. On the spontaneous
generat ion debate in general see Henry Harr is,
Things Come to Life. Spontaneous Generation Revisited,
O x f o r d , O x f o r d Universi ty Press, 2002, especially pp.
I -8.The dist inct and complex debate on whe ther the
first humans arose spontaneously has recently been
discussed by Mat thew R. G o o d r u m in A t o m i s m ,
atheism, and the spontaneous generat ion of human
beings: the debate over the natural origin of the f irst
humans in seventeenth-century Bri tain' Journal of the
History of Ideas 2002, vol . 63, pp. 207-24.
I I James Rueff, The Expert Midwife, or an Excellent and
most necessary Treatise of the generation and birth of
Man..., London, E.G. fo r S.E., 1637, p. 140. Edward
Fenton, Certaine secrete wonders of Nature..., London,
H. Bynneman, 1569, fo l . 12r, w r o t e that: 'women
per forming the desire of the fleshe being in the i r
Sanguine menstruate, bring f o r t h these monsters.'
12 Pliny the Elder, Historiae Naturalis book 28, ch. 23
gives an extensive account of the harmful effects of
menstruat ing w o m e n . A rich source of material of
the cont inuing t rad i t ion of menstrual taboo in
Medieval Europe is De Secretis Muiierum, w r i t t en
c.l 400 by a disciple of A lber tus Magnus: see Helen
Rodnite Lemay (ed. & transl.) Women 's Secrets, N e w
York, State Universi ty of N e w York Press, 1992, pp.
32-47, 75, 89, 96, 129-32, 134. Monica H. Green, 'The
transmission of ancient theor ies of female physiology
and disease through the early middle ages' PhD,
Princeton University, 1985, examined the classical
basis of Medieval concepts.
13 On the concept o f 'menst rua l regulation' see Etienne
van de Wa l le and Elisha P. Renne, Regulating
Menstruation: Beliefs, Practices, Interpretations. Chicago,
The University of Chicago Press, 2001 .
11
T h e s o o t e r k i n dissected,Vesal ius, I X , 2 , 6 -14 , 2 0 0 3
14 Wi l l iam Harvey, fo r example, held this Ar istote l ian
posit ion, see his Disputations Touching the Generation
of Animals (transl. Gweneth Wh i t te r idge) O x f o r d ,
Blackwell, 1981, pp. 374-90.
15 2 Esdras 5, 8 : 'and menstruous w o m e n shall bring
fo r th monsters.'
16 G. Havers (transl.), A General Collection of Discourses
oftheVirtuosi of France..., London,Thomas Dr ing and
John Starkey, 1664, p. 185.
17 Q u o t e d in Palmer Findley, Priests of Lucina.The Story
of Obstetrics. Boston, Li t t le, B rown and Co., 1939, p.
8 1 , his translat ion.
18 della Porta, op. cit. book 2, pp. 28-9.
19 [Gui l laume Mauquest de] La Mo t t e (transl. Thomas
Tomkyns), A General Treatise of Midwifry: Illustrated
With upwards of Four Hundred curious Observations
and Reflexions concerning that Art, London, fo r James
Waugh, 1746, p. 56.
20 Hi lary Marland (ed. & transl.), 'Mo the r and Chi ld
W e r e Saved.' The memoi rs (1693-1740) of the
Frisian midwi fe Catharina Schrader, Ams te rdam,
Rodopi , 1987, p. 84.
21 Jacques Gelis, History of Childbirth. Fertility, pregnancy
and birth in early modern Europe, Polity Press, O x f o r d ,
1991, p. 259. As sooterk ins had a wel l-def ined
st ructure it is more likely that macerated tw in
foetuses or chorangiopagus parasites w e r e
in terpreted in this way.
La Mot te , op. cit, p. 24.
Nicholas Remy (ed. Montague Summers, transl. E.A.
Ashw in ) , Demonolatry, Secaucus, NJ, Un ivers i ty
Books, 1974, p. 2 1 .
Except for the extremely rare possibility that one of
dizygotic twins is a mole. A statement by Francois
Mauriceau in his Traite des Maladies des Femmes
Grosses, et de celles qui sont accouchees..., Paris, Chez
I'Auteur, 1681, pp. 109-10 that 'Somet imes there is a
Chi ld together w i th a Mole' was based on an
anencephalic child in which the area cerebrovasculosa
was referred to as a mole.This however was a non
standard use of the t e r m .
25 Ibid., p. 106.
26 Francois Mauriceau (transl. Hugh Chamber len), The
Diseases of Women with Child, and in Child-bed: as also
the best Means of helping them in Natural and
Unnatural Labours. With fit Remedies for the several
Indispositions of New-born Babes..., 3rd edn, London,
fo r And rew Bell, 1697, p. 42.
27 Rueff, op. cit., p. I 38.
28 Mauriceau (transl. Chamber len), op. cit, p. 26.
29 Ibid., p. 4 1 .
30 Ibid., p. 43.
31 See Jan Bondeson, The Feejee Mermaid and Other
22
23
24
Essays in Natural and Unnatural History, Ithaca, Cornel l
Universi ty Press, 1999, p. 199.
32 Problems 878a, 18-24. N o t the w o r k of Ar is to t le . The
earliest edi t ion was pr inted in 1475 in Rome.
33 Pare, op. cit., p. 5. See also Rober t Hole, 'Incest,
consanguini ty and a mons t rous b i r th in rura l
England, January 1600', Social History 2000, vol. 25, pp.
183-99.
34 On the life of Liceti see J.C.F. Hoefer's article in
Nouvelle Biographie Generate, Paris, D idot , I860, pp.
132-6 and on his w o r k on monstrous births A . W
Bates, 'The De Monstrorum of Fortunio Liceti: a
landmark of descriptive terato logy ' Journal of Medical
Biography 2001 vol . 9, pp. 49-54.
35 This opinion was based on Ar is to t le , Generation of
Animals 769b 10-25:'The likeness of monstrosit ies to
animals is mere ly resemblance. The i r di f fer ing
gestation periods prevent mixtures of one animal in
another.'
36 Ibid., pp. 191 -2. Liceti was a suppor ter of the classical
t heo ry of spontaneous generat ion, as shown by his
De Spontaneo Viventium Orto, Vicenza, 1618. He also
accepted the viability of animal-human hybrids (a
rare point of disagreement w i th Ar is tot le) which he
at t r ibuted, as had Pare and others, to bestiality.
37 For tun io Liceti, De Monstrorum Caussis, Natura, &
Differentiis, Padua, Paul Frambot t , 1634, p. 191.
38 Though Ar is to t le does no t give exact t imes. See his
Historia Animalium 583b 10-20.
39 Bayle, 'Dissertat iones physicae in quibus principia
propr ie ta tum in mixt is, aeconomia in Plantis &
animalibus, causa & signa propensionum in homine
&c. demonstrantur ' , Journal des Savans 1677, pp. 161-
3.
40 'Praegnantem enim operar i per mul tam
apprehens ionem, atque f oe tum nonnunquam
t ransformare omnio , imo ab humana natura in
bel lu inam [sic] t rans f igurare . . . ' : Andreae Low,
'Foetus, qua caput, monstrosus' Miscellanea Curiosa
1690, series 2, vol . 9, pp. 200-2.
41 Joyce F. Salisbury, The Beast Within: Animals in the
Middle Ages. N e w York, Routledge, 1994.
42 Erica Fudge, 'Monst rous acts: bestiality in early
modern England' HistoryToday, 2000, vol. 50, pp. 20-5.
43 Ar istot le 's Generation of Animals pointed the way to
this: see book 3, ch. 2.
A u t h o r
Alan Bates PhD studied embryology at Queen Mary
College, London.
Address
Depar tmen t of Histopathology
Royal Free Hospital
London N W 3 2 Q G
12
The sooterkin dissected.Vesalius, IX, 2, 6-14, 2003
Tfie Female Physician... published in 1724. By kind permission of the British Library (I 177.C.2)
13
The sooterkin dissected,Vesalius, IX, 2, 6-14, 2003
Title page of Fortunio Liceti's De Monstris
M a n - m i d w i v e s examine Mary Toft in Hogarth's Cunicularii. Maubray, fourth from the right, is exclaiming 'a sooterkin'
14
S t u t t e r i n g in ant iqui ty ,Vesal ius , I X , 2 , 15-18, 2003
Stuttering in antiquity -Moses and Demosthenes
Assi Cicurel and Shifra Shvarts
I n t roduc t ion
The w o r d stut ter ing, (also stammering or logospasm)
comes f rom the gothic stautan - to strike, ( l ) Stutter ing is
a disturbance in the fluency and t ime patterning of
speech that is inappropriate fo r the person's age.
Stuttering consists ei ther of repet i t ions, prolongat ions,
pauses wi th in words , observable w o r d substitut ions to
avoid blocking, or audible or silent blocking, all of which
disrupt the rhythmic f low of speech.(23) The individual
knows precisely what he or she wishes to say, but at the
same t ime may have difficulty saying it.(4)
The prevalence of stut ter ing in the general populat ion
has been estimated to be between land 5 %.(456) It is
likely that the condi t ion of s tut ter ing has been known
since humans f irst began to speak. Indeed, evidence of
stutter ing can be inferred f rom ancient w r i t t en records
in Egypt, Mesopotamia and China.*7 8)
There are many theor ies as to the reasons fo r
stutter ing, in fact, the disorder has been called ' the
disorder of many theor ies ' , (Jonas Gerald 1978). But to
this day, no theory has been indisputably proven,*6 9) and
more importantly, no t rea tment fo r the disorder has
been fully effective.*910) These facts emphasize the
relevancy of a discussion of the prob lem f r om the
historical point of view. Perhaps some insights might be
gained by re-examining histor ical accounts of the
disorder. In addit ion, historical examples of coping w i th
s tu t te r ing might have therapeut ic value as
bibliotherapy.*"12 '
This ar t ic le wi l l present t w o cases of famous
stutterers f rom antiquity - Moses and Demosthenes. In
each case a descript ion of the person and his stut ter ing
wi l l be given. Then the different ways of coping w i th the
problem and the various etiological theor ies that can be
derived f rom the t ex t wi l l be considered and finally
modern relevancy wi l l be discussed.
Moses
Moses - the leader and l iberator of the Hebrews f rom
slavery, suffered probably, f rom stut ter ing. This can be
inferred f rom the f irst t ime stut ter ing is ment ioned in
the Bible, in the fo l lowing verses.
As Moses stands in f ron t of the burning bush, the Lord
commands him to lead his people to f reedom and Moses
responds:
'And Moses said unto the LORD, I am not eloquent,
neither heretofore, nor since thou has spoken to thy
servant: but I am slow of speech, and of a slow tongue.
And the LORD said unto him, who hath made man's
mouth?
Or who maketh the dumb, or deaf, or the seeing, or the
blind? have not I the LORD?
Now therefore go, and I will be with thy mouth and
teach thee what thou shalt say.
And he said, 0 my Lord, send I pray thee, by the hand
of him who thou wilt send.
And the anger of the LORD was kindled against Moses
and he said is not Aaron the Levite thy brother? I know
that he can speak well And also behold, he cometh forth
to meet thee: and when he seeth thee, he will be glad in
his heart.
And thou shall speak unto him, and put words in his
mouth: and I will be with thy mouth, and with his mouth,
and will teach you what ye shall do.
And he shall be thy spokesman unto the people; and he
shall be, even he shall be to thee instead of a mouth,
and thou shall be to him instead of GOD.'(Exodus 4,10-
16).
Moses gives a different descr ipt ion of his speech
difficulty in another verse :
'And Moses said before the LORD, Behold, I am of
uncircumcised lips, and how shall Pharaoh hearken unto
me?' (Exodus 6,30).
These verses contain a large amount of informat ion
about the proposed et iology of Moses' stut ter ing, its
durat ion and his ways of contending w i th the problem.
In the f irst t ex t Moses states that he is 'not eloquent',
and, 'slow of speech and of a slow tongue', (the Hebrew
original uses the expression heavy mouth [kevad-pe]
instead of s low of speech). In the second tex t Moses
describes his stut ter ing as 'uncircumcised lips'.
'Neither heretofore, nor since thou hast spoken to thy
15
Summary
Two famous stutterers from history are considered, Moses and Demosthenes, from historical accounts. Different
ways of dealing with the problem and various etiological theories are discussed. The modern relevance of these
examples is reviewed.
Résumé
L'histoire de deux célèbres bègues, Moïse et Demosthenes, encore présente dans toutes les mémoires, est ici
rapportée. La façon différente dont ces deux bègues utilisèrent leur infirmité pour mieux la surmonter et les théories
étiologiques variées mises en avant pour expliquer leur symptômes sont discutées. La pertinence que représente, de
nos jours, ces deux cas historiques de bégaiement fait également l'objet d'une discussion.
Stuttering in antiquity,Vesalius, IX, 2, 15-18,2003
servant'- Moses testifies that he suffered f r om the
disorder fo r a long t ime. Stutter ing usually appears in
ch i ldhood ; t he re fo re i t is possible to v iew this
descript ion as a reliable po r t ra i t of a cont inuing long-
t e rm chronic prob lem rather than an acute prob lem
caused by tempora ry exci tement.
The descr ip t ions 's low tongue ' , 'heavy m o u t h ' ,
'uncircumcised lips' suggest a percept ion of s tut ter ing as
an organic d isorder of the upper, (and most visible),
speech organs - the mou th , tongue and lips. Similar
theor ies recur th roughout h istory unti l the t u rn of the
nineteenth century, w i th surgery on the tongue being
per formed by respectable surgeons. Today, stut ter ing is
also perceived, (by some researchers), as a biological,
organic, and partially genetic disorder.
God himself declares that he is the cause of stut ter ing
as wel l as o the r disabilit ies. It is interest ing that
stut ter ing is ment ioned here by G o d , together or in
comparison w i th dumbness, deafness and blindness.
It is notable that God's promise to be 'with the mouth
of Moses,' does no t satisfy Moses. Moses' reaction shows
the degree of his fear, his v iew of the severity of the
problem and his lack of confidence, caused by years of
speech difficulties. Moses' claims to be 'not eloquent' may
be seen as a strategy fo r avoiding speaking. Avoidance,
the use of another person fo r speaking, is a c o m m o n
strategy fo r stut terers dealing w i t h the disorder'6 ' , and
interestingly enough this is the only solut ion that
satisfies Moses.
Ano the r account of the cause of Moses' s tut ter ing is
the in terpretat ion of the tex t of Exodus ['Midrash of
Shmot Rabah']. Moses was raised by the daughter of
Pharaoh in the Palace. One day, when Pharaoh had the
l i t t le child in his lap, l i t t le Moses t o o k Pharaoh's c rown
and put it on his head. The King's counsellors were
shocked and feared that the foreign boy wanted to steal
the k ingdom, and so they const ructed a test: t w o bowls
were put in f ron t of the boy. One w i th pure gold and the
o ther w i th sizzling coals. If Moses was to take the gold,
the greedy boy wou ld be kil led. If he touched the coal
then only the sparkle at t racted him and he wou ld be
pronounced innocent. W h e n the bowls were set, Moses
reached fo r the gold, but the angel Gabriel d i rected him
to the coal.The l i tt le boy put the coal in his mou th and
thereupon became a stutterer. ( l3 ) Again we find a t heo ry
that suggests a physical (organic) origin of stut ter ing.
Certa in researchers suggest that, if the s tory really
happened, the stut ter ing of Moses could have developed
f rom the t rauma of such a test.( l4) Some modern
researchers th ink that Moses did not suffer f r o m
stut ter ing but f r om a more apparent physical defect -
cleft palate for example, owing to the use of the
expressions 'heavy mouth' and 'uncircumcised lips' that
may describe a physical flaw and no t a prob lem w i t h
speech itself. To ou r mind, this disposit ion seems
untenable. A cleft palate is a physical imperfect ion, a
defect. A cleft palate wou ld be evident f r om bi r th and
wou ld cause the child to appear deformed, contradict ing
the fact that the Pharaoh's daughter saw a perfect baby
and adopted him. It wou ld have been unlikely fo r her to
adopt an imperfect child. In fact, Moses was considered
by many authori t ies to be a beautiful perfect child, so
beautiful that everyone that saw him was astounded."5 '
Moreover, a cleft palate is a 'lack' of tissue, a gap in the
who le , whi le the expression uncircumcised, suggests that
something is added, or untouched, and not missing.
D e m o s t h e n e s
Demosthenes (384-322 B.C.), the Athen ian
recognized as the greatest Greek o ra to r of ancient
t imes, and perhaps one of the greatest orators ever, also
stuttered.'16 ' His life was described by Plutarch. He was
born to an honourable and r ich family near Athens -
'Demosthenes the father of Demosthenes, belonged to
the bet ter class of citizens... He had a large factory and
slaves...''17' His father died when he was seven years old
and left a considerable inher i tance. However, the
inher i tance was s to len by his guardians, and
Demosthenes was forced to live in poverty, pampered by
his mother, deprived of the education usual for his class,
and lacking physical activity and discipline.'18' He was
feeble and unhealthy and children mocked him fo r his
stut ter ing and called him Battalus or Argas.'8' The t e rm
Battalus was used as a nickname for stut terers, and was
used as a scientific t e r m describing stut ter ing for many
years.The name Argas was given to him either because
of his manners, which were harsh and savage, (Argas
being one of the poetical names for a snake), or because
of his way of speaking, which was distressing to his
hearers, (Argas being the name of a composer of vile and
disagreeable songs).'17'
As Demosthenes g rew up, he left his studies,
abandoned youthful games and devoted himself to the
study of oratory . He stut tered badly when beginning his
orator ical career, as Cicero humorously describes - 'at
f i rst s tut ter ing so badly as to be unable to pronounce
the initial R of the name of the ar t of his devotion
(Rhetorica).'"9 '
The f irst t ime he addressed the people was a total
failure. Demosthenes 'was in ter rupted by thei r clamours
and laugh... he had a weakness of voice and indistinctness
of speech and shortness of breath which disturbed the
sense of what he said by disjoining his sentences.'"7'
Later, he met Eunomus, the Thracian, then an old man,
w h o praised his speech, comparing i t to that of Pericles.
Eunomus claimed that Demosthenes' t roubles as a
speaker arose f r om cowardliness, weakness of spirit and
neglect of the body.
16
S t u t t e r i n g in ant iqui ty ,Vesal ius , I X , 2 , 15-18 , 2003
On another occasion, fo l lowing a fu r ther disgrace in
the assembly, Demosthenes met an acquaintance- the
actor Satyrus. Demosthenes complained that despite the
t remendous effort he had invested in preparing and
delivering the speeches -even fools and sailors received
more a t ten t ion when ta lk ing. Satyrus convinced
Demosthenes to practise by recit ing w i th him using
p roper expressions, p ronunc ia t ion , mimicry , and
emot ion . Under Satyrus' encouragement Demosthenes
started a relentless program to defeat stut ter ing. Every
day he practised his voice in the basement of his house.
Sometimes he stayed there fo r months, shaving half of
his head to prevent himself f rom going out. Even small-
talk became an exercise. Every speech he heard was
dismantled into t iny fractions and repeated over and
over, pronounced differently each t ime. It was said that:
'For his bodily deficiencies he adopted the exercises...
taking pebbles in his mouth and then recit ing speeches.
His voice he used to exercise by discoursing whi le
running or going up steep places, and by recit ing
speeches or verses at a single breath... He had in his
house a large looking glass, and in f ron t of this he used
to stand and go through his exercises.''201
Demosthenes succeeded in his endeavour and
transformed himself into a great and famous orator. His
adversary Iscines called him ' the greatest in his
speeches,' saying, when he had rec i ted one of
Demosthenes ' speeches in Rhodes and received
applause 'what can you say if you heard the beast
itself?''2"
In spite of his t remendous success, he was probably
no t cured f r o m s tu t te r ing . He avoided speaking
spontaneously, all his speeches being met iculously
prepared and rehearsed wel l in advance. Those w h o
opposed him mocked him fo r that, whi le even those
w h o suppor ted him complained, Dimades his ally,
complaining that Demosthenes never spontaneously
defended him in a debate. Demosthenes responded by
saying 'He w h o rehearsed his speeches was a t rue man
of the people.''20'
The story of Demosthenes raises a number of points
for considerat ion. There is the connect ion between
physical flaws or weaknesses of the body and stut ter ing
- Demosthenes grew up as a feeble and sickly child.
There is the view of Eunomus, cit ing fear of an audience,
lack of courage, and lack of preparing the body fo r the
speech. This suggests a more complex t h e o r y of
s tu t te r ing - a connec t ion w i t h fears and mental
weakness, and a relationship of body and speech). From
the way Demosthenes confronted his stut ter ing, and
f rom the way Satyrus practised w i th him, i t appears that
Demosthenes and Satyrus believed that stut ter ing, (and
fluency), was a learned behaviour.
There is the durat ion of the disorder to consider,
Demosthenes is clearly described as stut ter ing f r om
chi ldhood.There is the use by Demosthenes of a speech
pathologist / therapist - Satyrus, perhaps one of the f irst
speech therapists in all history,'22' w i t h a method of
therapy that could be implemented today. Demosthenes
recited f r om Euripides and Sophocles, and Satyrus
reci ted after h im, in a different (correct ) manner. An
example of a similar valid method of t rea tment today is
t he Shadow m e t h o d , w h e r e ' the s tu t t e re r
fo l lows/ repeats the w o r d s spoken by a speech
therapist.''4 '
There is the fact that Satyrus was an actor and not a
man of medicine. A l though Greek phi losophers and
doctors , like Ar i s to t le and Hippocrates, did discuss the
prob lem at length, it seems that stut ter ing and speech
pathology th roughou t h istory has been t reated by non
medical therapists.'8 ' To this day, t rea tment is generally
given by speech pathologists and no t by medical doctors ,
an interesting and puzzling fact.
Demos thenes developed a 'self help ' extensive
therapy plan, which focused on relentless practice to t r y
to make the rebell ious organs of speech w o r k properly.
He also meticulously prepared his speeches, and avoided
speaking spontaneously, an anxiety decreasing technique.
His methods are surprisingly similar to cur rent speech
therapy, which essentially views stut ter ing as a learned
behaviour. '6 'Therapy changes the maladaptive behaviour
by recons t ruc t ing the resp i ra tory , phona to r y and
ar t icu la tory gestures wh ich generate speech. Some
therapies strive to reshape completely the speech of the
stutterer, making it sound fluent. Rate reduct ion, easy
onset of voice, and smooth t ransi t ion between sounds
are all achieved by repet i t i ve p ronunc ia t ion , and
practice.'10 '
Plutarch compares the ef for ts and success of
Demosthenes to Laomedon the Orchomenian, w h o
'practised long distance running by the advice of his
physicians, to ward off some disease of the spleen, and
then after restor ing his health, entered the great games
and became one of the best runners.' '20 'This comparison
raises the interesting quest ion- to what degree did
v i c t o r y in t he relent less bat t le w i t h s tu t te r ing ,
cont r ibu te to the making of the orator? Demosthenes
probably believed that f luency was a learned behaviour,
and that through exercise he wou ld achieve fluency.This
interesting t heo ry of speech and stut ter ing as a learned
behaviour, and therapy w i t h reci t ing and pract ice,
remains popular today.'7'
Conclus ions
We have presented t w o case studies of s tut terers,
Moses and Demosthenes . They bo th g rew up in
respectable families and stut tered f r om a very early age.
In both stories there is reference to the mother 's role.
17
S t u t t e r i n g in ant iqu i ty , Vesal ius, I X , 2 , 15-18, 2 0 0 3
Moses was raised by the Pharaoh's daughter w i th no
ment ion of a father f igure, Demosthenes' father died in
his chi ldhood and his mother pampered him. The t w o
suffered f r om a severe s tu t ter (Moses declared that he
refrained f rom speaking, Demosthenes was mocked and
called by names because of his s tu t ter ing) .Whatever the
inspirat ion, and despite the severity of the i r s tut ter ing,
they assumed a posit ion in society that required an
exceptional ability to speak and communicate - an ability
unexpected f r om a stutterer. In discussing the t w o cases,
we can see etiological theor ies that are still relevant to
the theoret ical debate concerning stut ter ing, (organicity
in stut ter ing in the case of Moses and stut ter ing as a
psychological or neurot ic p rob lem in the case of
Demosthenes) . Anc ien t therapies are largely stil l
relevant today.
Discussing the h is tory of s tut ter ing is, as Van Riper
e loquent ly w r o t e , a humbl ing exper ience fo r the
contemporary scholar. ' W e see concepts bo rn , revised,
and reborn.. .we also see that most of our present beliefs
were formulated, at least in germinal f o r m , and even
discarded long ago...'(7) Al l this serves to emphasize the
relevancy of the historical v iew of medicine in general
and of the riddle of s tut ter ing in particular. Finally, the
cases discussed are examples of success in the face of
mockery, lack of belief, and insecurity. The stut ter ing of
Moses and Demosthenes did n o t l im i t t he i r
advancement to power and to careers in which the use
of speech was so impor tant . In ou r view, both cases are
as relevant today as they were 2000 years ago, and just
as inspiring. Therefore there is great potential in these
stories as a bibl iotherapic aid in the t rea tment of
stut ter ing.
T h e A u t h o r s
Assi Cicurel MD and Shifra Shvarts PhD
Address fo r correspondence:
Prof Shifra Shvarts
Chair Depar tment of health systems management
Faculty of Health Sciences
Ben Gur ion University, beer Sheva 84105 Israel
Email; [email protected]
Bibl iography
1. Hensyl W.R (ed.). Stedman's Medical Dictionary 25th
Edition. Bal t imore:Wi l l iams & W i l k i n s , 1990.
2. Amer ican Psychiatric Associat ion. Diagnostic and
Statistical Manual of Mental Disorders (DSM-/V). 4th
Ed. Washington:The Associat ion, 1994.
3. W o r l d Health Organizat ion. The ICD-IO Classification
of Mental and Behavioral Disorders Clinical Descriptions
and Diagnostic Guidelines. Geneva: W H O , 1992.
4. Lawrence M & Barclay D.M III. 'Stutter ing: A Brief
Review.' In: American Family Physician (May 1998).
5. Andrews Gavin . 'Chapter on Epidemiology of
Stut ter ing. ' Chap, in Nature and Treatment of
Stuttering New Directions (ed. Richard f. Curlee &
Wi//iam H Perkins). 1-12: London, Taylor & Francis
1982.
6. Kaplan H.I. & Sadock B.I., Textbook of psychiatry.
Synopsis of Psychiatry. Bal t imore, Maryland, USA:
Wi l l iams & W i l k i n s , 1998.
7. Van Riper Char les, book . THE NATURE OF
STUTTERING. I l l inois:Waeland Press, 1992.
8. Bobr ick Benson, h istor ical book . KNOTTED
TONGUES. N e w York: Kondasha, l996.
9. Nat iona l Inst i tu te on Deafness and O t h e r
Communicat ion Disorders, National Institutes of
Heal th. ' N I D C D Heal th In format ion. Stuttering.'
Http:/ /www.nidcd.nih.gov/textonly/health/pubs_vsl/s
tu t te r .h tm: N I D C D , N I H , 1997.
10. Daniel Costa, Rober t Kro l l . 'S tu t te r ing : an Update
fo r Physicians' In Canadian Medical Association Journal
(CMAJ) (Canada) 162, 13 (June 2000): 1849-55.
I I. Duncan M. 'Clinical Use of Fiction and Biography
Featuring Stuttering.' Journal of Speech and Hearing
Disorders, 10 (November 1945): 205-210.
12. Emerick L. I. 'Bibl iotherapy fo r Stuttering - Four
Case Studies.' Quarterly Journal of Speech (74-79)
(1966).
13. Julius Preuss. Biblical and Talmudic Medicine (tr. & ed.
Rosner F.). N e w York: Sanhedrin Press, 1978.
14. Garf inkel, H . ' W h y Did Moses Stut ter and W h y Was
Moses Left Handed?' Journal of the Royal Society of
Medicine (England) 88, 5 (May 1995): 256-7.
15. Flavius Josephus. The Complete Works (translated byW.
Whiston.).Thomas Nelson, 1998.
16. Encyclopaedia Britannica, 2001.
17. Plutarch, t rans la t ion of w o r k . Plutarch's Lives
(Translated by Bernadotte Perrin) Vol. VII. London:
W i l l i am Heinemann Ltd. , 1928.
18. Herodotus , historical book. History (tr. A.D. Godley).
London:Wi l l iam Heinemann, 1924.
19. Marcus Tullius Cicero, t ranslat ion of w o r k . De
Oratore, Book I (Translated by E.W.Sutton, H.Rackham).
Cambr idge Massachusetts: Harvard Univers i ty
Press, 1988
20. Plutarch, translat ion of wo rk . Plutarch's Lives - The Live
Of The Noble Grecians and Romans (tr. John Dryden).
N e w York: Random House (The Modern Library).
2 1 . McQueen E.I, book. DEMOSTHENES OLYNTHUIACS.
Cambridge: Cambridge University Press, 1966.
22. Klingbeil G.M. T h e Histor ical Background of the
Modern Speech Cl in ic ' Journal of Speech Disorders 4
(1939): 115-132.
18
L a n g e r h a n s i n t h e M i d d l e Eas t .Vesa l i us , I X , 2 , 1 9 - 2 1 , 2 0 0 3
Langerhans in the Middle East: More about the discoverer of the pancreatic islets
Efraim Lev, Karin Ohry-Kossoy and Avi Ohry
L i fe a n d W o r k
Paul Langerhans was born in Berlin in 1847. His father
was a wel l known physician and local polit ician, and t w o
of his b ro thers we re also physicians. He studied
medicine f irst in Jena, then in Berlin. He was for tunate to
have several famous teachers such as Langenbeck and
Haeckel, but in part icular Rudolf V i rchow, the founder of
modern pathology, and Julius Cohnheim. Both influenced
young Langerhans, V i r chow also becoming a close
personal friend.'121
Whi l e still an undergraduate student, Langerhans
worked inVirchow's laboratory and made his f i rst major
histological discovery. He used the gold chlor ide staining
technique of his teacher Cohnhe im to describe new skin
cells, thei r funct ion however remaining unknown to
him. [35] Since then called Langerhans cells, they were
shown only in 1973 to play a role in the immune system.
Langerhans published his findings in 1868 in an art icle in
Virchow's Archiv, in which he also described the stratum
granulosum known as the layer of Langerhans.161
He achieved his most famous discovery, the pancreatic
islets, also as a student, between 1867 and 1869 dur ing
his research for his MD thesis, again w i t hou t knowing
the funct ion of these cells.U] It was E. Laguesse of Lille
(France) w h o f irst w r o t e in 1893 that these 'islets of
Langerhans' could be the source of an internal secret ion;
because he named them "islets', the ho rmone they
produced wou ld be called insulin 30 years later.
In 1870 Langerhans wen t to the Middle East on a
scientific journey, about which more wi l l be said later. He
served as medical off icer in the Prussian army during the
1870-1871 wa r against France. He then became
professor of pathology at Freiburg im Breisgau, a
promising career which he had to renounce very soon
after when he became ill w i th pulmonary tuberculosis.
This was also the reason fo r his decision to go to the
Portuguese island of Madeira, the cl imate of which was
then believed to be good fo r his condi t ion. He did
improve there and started practicing medicine, as wel l as
studying the local marine fauna. Sending his papers to
the Berlin Academy of Sciences, he described over 50
new varieties of marine wo rms . Some of them were
named after h im, whi le he called one Virchowa in honour
of his men to r and f r iend. In 1885 he published a guide to
Madeira.1891 He died there in 1888, aged only 4 I . [ I 0 1
L a n g e r h a n s i n t h e M i d d l e Eas t
It was V i r chow w h o suggested to Langerhans that he
should join a scientific expedi t ion to the Middle East led
by the geographers Heinr ich K ieper t and his son
Richard (1846-1915). Paul wou ld be the team physician
and could conduct his o w n research in his spare t ime.
The original idea was to attend the Suez Canal
opening celebrations before explor ing the region, but
this did no t come about. The team left Germany in
March 1870 fo r Egypt, where they visited Alexandria and
Cairo, cont inuing to Jaffa, f r om where they headed fo r
Jerusalem, the departure point for thei r tr ips in the area.
In early Ap r i l the team u n d e r t o o k a th ree -week
expedi t ion to eastern Jordan. In May Heinr ich K ieper t
wen t alone to western Jordan because Richard came
down w i th typhoid fever. Paul remained w i th Richard in
Jerusalem, concentrat ing on the t w o subjects which
par t icu lar ly in te res ted h im in the Ho ly Land:
anthropological study of the local populat ion, and
leprosy. In early June Langerhans and the Kieperts sailed
f r om the p o r t of Jaffa, stopping in Beirut, visiting
Damascus, then cont inuing to Cyprus, Rhodes, and
19
Summary
Paul Langerhans is forever associated with the discovery of the pancreatic islets which bear his name. His numerous
other contributions to anatomy, pathology, anthropology, and clinical medicine (particularly leprosy and tuberculosis)
are less known. In 1870 he joined the Kieperts, father and son, two noted German geographers, on an expedition to
the Middle East. His clinical and anthropological findings from this journey appeared in the journal published by his
famous mentor, Rudolf Virchow. Langerhans later fell ill with tuberculosis and spent his last years on the island of
Madeira, where he continued to investigate, practise medicine, and write.
Résumé
Le nom de Paul Langerhans est à jamais associé à la découverte des îlots du pancréas qui portent son nom. Ses
nombreuses autres contributions dans les champs de l'anatomie, de la pathologie et de la médecine (en particulier, la
lèpre et la tuberculose) sont moins bien connues. En 1870, Langerhans participa, avec les Kieperts, père et fils, deux
géographes allemands très connus, à une expédition au Proche-Orient. Les résultats des recherches cliniques et
anthropologiques entreprises au cours de ce voyage furent publiés dans le journal de son célèbre mentor, Rudolf
Virchow. Plus tard, Langerhans dévellopa une tuberculose; les dernières années de sa vie se passèrent dans l'île de
Madère, où il continua ses activités de recherche, de pratique clinique et d'écriture.
Langerhans in t h e M i d d l e East ,Vesal ius, I X , 2 , 1 9 - 2 1 , 2003
Istanbul. From there they wen t to Vienna and re turned
to Berlin in July 1870.
A n t h r o p o l o g y
Langerhans conducted his research by systematically
measuring the skulls of the natives, mainly Bedouins, in
Jerusalem, Jericho, and the East Bank of the r iver Jordan.
He also photographed and sketched them. Thanks to
informat ion he obtained f r om the locals he was able to
co l lec t skeletons at var ious sites. The biggest
cont r ibu t ion to his pro ject was made by the Beni Aduan
and the Beni Sacher tr ibes. Apa r t f r om the similarity he
found between some of the local faces and the pictures
of the f irst Christ ian saints, he concluded that f r om an
anthropological point of view there were three main
groups in the populat ion of the Holy Land:
1. The Bedouin or nomads
2. The fellahin or Arab farmers
3. The t o w n dwellers, including Europeans.
He repor ted his findings to V i rchow, w h o published
them in his Archiv.l"]
Leprosy
W h e n Langerhans visited the t w o leper colonies
existing in Jerusalem in 1870, the medical w o r l d was still
in the dark about this ancient scourge of mankind.Three
years later (1873) A. Hansen of No rway described
mycobac te r ium leprae, but effect ive l ong - te rm
t rea tment only came in 1941 w i t h the in t roduct ion of
Promin injections. Langerhans w r o t e to V i r chow that the
medical standard in Jerusalem was very low, even worse
than in Cairo, because rel igion, instead of science,
con t ro l l ed the s i tuat ion. The re w e r e ne i ther
pos tmor tem examinations nor a medical l ibrary. Patients
w i th leprosy were no t admit ted to any of the general
hospitals in the city. The f irst leprosarium he saw
consisted of 15 miserable, d i r ty barracks located near
Z ion Gate, home to 25 people w h o subsisted on
begging.Their chi ldren were raised outside the colony by
o ther family members living in the city.
Since no children had been born to them after the
lepers came to live on the site, Langerhans concluded
that reproduct ive ability is lost once the disease is
contracted. No t reatment , medical or other, was given to
these people. There were leper colonies in Nablus,
Hebron , and Ramleh to which Langerhans did no t go, but
he did visit the o ther one in Jerusalem, established in
1867 by Baron and Baroness Keffenbrinck-Ascheraden
f rom Germany.This couple had tou red the Holy Land in
1865 and after having been shown around by Dr.
Chapl in, an English physician w h o investigated the
disease, they decided to alleviate the terr ib le condit ions
the lepers lived in by building an asylum in Jerusalem.
They appointed Chaplin as one of the directors of the
inst i tut ion. It opened under the name Jesus Hilfe and
Chaplin became its chief physician, a post he held until
1886 when he left Jerusalem. His successor was Dr.
Wheeler , w h o w r o t e that Chaplin 'made a careful and
systematic examination of each leper in Jerusalem and
Ramleh, and was at that t ime one of the authorit ies on
leprosy.'1'21 In 1870 Jesus Hilfe had 12 patients and was a
bet ter place than the leprosarium at Z ion Gate. Chaplin
was the physician in charge.'131 The staff consisted of a
German missionary, Mr. Tappert, his wife, and another
lady. Financial suppor t came f rom Germany while the
patients were Arabs. This brought Langerhans and
Chaplin to the conclusion that leprosy does not affect
Europeans. At least three of the patients Langerhans
examined there were not lepers. One suffered f rom
psoriasis, one f rom elephantiasis, and one f rom some
fo rm of arthr i t is. He was curious about the etiology of
the disease, wonder ing if i t was inheri ted, due to
contaminated food , etc., but he returned to Berlin
w i t h o u t any new answers. [ l4 ] Upon his re turn home his
scientific career was put on hold because of the Franco-
Prussian W a r (1870-71), in which he served as medical
officer, but immediately after it he was appointed to his
f irst academic post.'1516]
The papers that resulted f r om his shor t t ime in the
Middle East in 1870 show the range of his interests, his
enquir ing mind and his ability to make the most of his
t ime.
Bibl iography
1. Hausen B. M.,'Paul Langerhans - Life and W o r k . Part
1. C h i l d h o o d , Early Educat ion, and Col lege
Education,' A m e r J Dermatopatho l 1987; 9(2): 151-
156.
2. Hausen B. M./Paul Langerhans - Life and W o r k . Part
2. Postgraduate Studies, Travels, First Signs of
Disease, Madeira,' A m e r J Dermatopatho l , 1987;
9(2): 157-162.
3. Jay, V, Th i s mon th in h istory - Paul Langerhans,'
J Roy Soc Med 1999; 92(1): 59.
4. Anon. , 'Papa Virchow,' The Lancet, 1958; 2:679-680.
5. Holubar, K., 'Paul W i l he lm Heinr ich Langerhans
(1847-1888), Z u m Gedenken seines Todestages am
20. Juli 1988.' W i e n e r Klinische Wochenschr i f t Bd
100, Schrift leitung O. Kraupp und E. Deutsch, N e w
York, W i e n : Springer-Verlag, 1988, pp.5 14-519.
6. Langerhans, P., ' Zu r pathologischen Anatomie der
Tastkorper,' Arch iv Patholog Ana tom Physiol Klin
Med, 1869;45:413-417.
20
Langerhans i n t h e M i d d l e Eas t ,Vesa l i us , I X , 2 , 1 9 - 2 1 , 2003
8.
9.
14
15
7. Langerhans, P., Cont r ibu t ions to the microscopic
anatomy of the pancreas, Berlin 1869; Reprint of the
German original w i th an English translat ion and an
in t roduc tory essay by Mor r ison H., Balt imore: Johns
Hopkins Press, 1937.
Langerhans, P., ' Zu r Aet io logie der Phthise.' Arch iv
Patholog Ana tom Physiolog Klin Med 1884; 97: 289-
306.
Langerhans, P., Handbuch fur Madeira. Berlin. 12*.
206 pp. 1885.
10. Sakula,A.,'Paul Langerhans (1847-1888):a centenary
tr ibute, ' J Roy Soc Med, 1988; 81 (7):414-415.
I I. Langerhans, P., 'Uber die heutigen Bewohner des
heiligen Landes, 'Archiv Anthropo log ie , 1873; 6:39-
58.
12. Wheeler, P. d'Erf., 'Eulogy: Dr. Thomas Chaplin,'
Palestine Explorat ion Fund Quar te r l y Statements,
1905,37:15
13. Lev, E. and Perry Y., T h o m a s Chaplin: The Great
English Doc to r ' (submitted to Palestine Explorat ion
Fund Quar ter ly Statements).
Langerhans, P.,'Lepra und Leproserien in Jerusalem,'
Archiv Patholog Ana tom Physiolog Klin Med, 1870;
50:453-455.
Langerhans, P.,'Zur Histologie des Herzens. 'Arch iv
Pathol Ana tom Physiolog Klin Med, 1873;60:5-91.
16. Langerhans, P., 'Ueber die accessorischen Drusen
der Geschlechtsorgane, ' A rch iv Pathol A n a t o m
Physiolog Klin Med, 1874;61:208-240.
Karin Ohry-Kossoy MA translator and editor, is co
author w i th A . O h r y of articles on the h is tory of
medicine.
Avi O h r y MD is Professor of Rehabil itation Medicine,Tel
Aviv University, Israel. He is a f o rmer chairman of the
Israel Society of the H is to ry of Medicine. His main
research interests are: general h istory of medicine, bio-
ethics, medical humanities, and rehabil i tat ion medicine.
Address: Sackler Faculty of Medicine,Tel Aviv University
& Rehabi l i ta t ion Medic ine Sect ion, Reuth Medical
Center,Tel Aviv, Israel.
A c k n o w l e d g m e n t s
The authors express thei r thanks to H.E. Mr. Shimon
Stein, Ambassador of Israel in Germany, fo r providing
access to Langerhans' original publications.
B i o g r a p h i c a l n o t e s :
Efraim Lev BA MSc PhD, is a researcher and lecturer at
Haifa University, Israel. He was the chairman of the Israel
Society of the His tory of Medicine (2002-2003). His
main research interests include: general h istory of
medicine in the Levant, ancient to medieval materia
medica, and ethnopharmacology. Current ly he is an
Overseas Vis i tor Scholar at St. John College, Cambridge
(2003-2004).
Address: Depar tment of Eretz-lsrael Studies, Universi ty
of Haifa, Israel 31905
Email: [email protected]
and
21
T h e 'Batavia," an a p o t h e c a r y , his m u t i n y a n d its vengeance,Vesa l ius , I X , 2 , 2 2 - 2 4 , 2 0 0 3
Almos t certainly the very f i rs t doc to r to dwel l , i f no t
actually practise, on Austral ian soil was a Dutchman,
Jeronimus Cornel isz. He arr ived on June 4th 1629, in less
than auspicious circumstances, having been shipwrecked
on the Abro lhos Islands, 70 kms off the coast of Wes te rn
Austral ia, due west of Gera ld ton and about 500 kms
no r th of the state capital Perth.
The Abro lhos had been f irst charted and t i t led in
1619. The name itself means 'open your eyes' or ' look
out ' in O l d Dutch, ( l ) wh ich is just wha t Cornel isz and his
mates on the Batavia did no t do. But it is wha t happened
after the shipwreck that gave Cornel isz his infamous
place in history.
Jeronimus Cornel isz was an apothecary by training
and plied his pills and pot ions in Haarlem in Holland. (2)
For reasons best known to himself, at the age of th i r ty ,
he abandoned his profession and jo ined the Dutch East
India Company (o r V O C as they knew it) as an
undermerchant.This was a rank on the Company's ships,
a kind of second mate. For the rest of his life he does
not seem to have used his medical skills, unti l as we shall
see, his very last day. In passing, the m o t t o of the V O C
was Jesus is good but Trade is better.
Jeronimus joined the new flagship and pr ide of the
V O C , the Batavia, on her maiden voyage. At 600 gross
tonnage and 43 metres in length, the ship was among the
largest vessels of her t ime. She was three t imes the
length of any of Columbus's caravels and tw ice as big as
the Bounty. As wooden ships go, she was a considerable
craft.(3)
She carr ied 332 souls, including many w o m e n and
chi ldren, a company of soldiers in case of pirates, and a
rich cargo of coins, jewels and ivory contained in 12
chests. Two hundred and ten of the ship's complement
were to die before reaching Batavia or Java, as it is now
called. In command of the small f leet of three ships, but
ensconced on the Batavia, was Francisco Pelsaert. The
skipper of the Batavia was Adriaan Jacobsz.
Despite having an engaging personality and refined
manners, undermerchant Cornel isz was at heart an evil
man and on the journey to the East Indies resolved wi th
others, probably including Captain Jacobsz, to take over
the ship and use it as a pirate vessel. However, before the
plans could be put into opera t ion , the navigator made
such a monumental miscalculation that they found
themselves 960 kms off course in a group of uncharted
and treacherous reefs off the Austral ian coast. Inevitably,
they wen t aground on wha t was then known as
Southland, or Terra Austral is Incognita, specifically on the
Morn ington Reef.
That was June 4th 1629. Forty people were drowned,
struggling to t r y to reach shore.They bypassed the low-
lying, so called Traitor's Island, and reached an elevated
piece of land, which they prompt ly called Batavia's
Graveyard. It is now called Beacon Island.
On June 6th Pelsaert, having found no water on the
adjacent low reef islands and no t able to land on the
precipitous coast of the mainland, elected to sail for
help. In doing so he made an unbelievably cavalier
decision, he omi t ted the t i resome chore of briefly
returning to the wreck site and tell ing his plans to those
left behind. Dur ing the eventual enquiry, his insouciance
was never quest ioned.
Pelsaert, using the only intact long boat, set off for
Batavia Island in what is now Indonesia. W i t h him went
all the senior officers, including Jacobsz, all the Company
22
Summary
In 1629, the Batavia, the flagship of the Dutch East India Company, was wrecked on the coast of what is now
Western Australia. One of the many survivors was Jeronimus Cornelisz, a Dutch apothecary. He took command on
shore, when the captain of the ship sailed on to get help. He led a bloody mutiny in which most of those shipwrecked
were massacred, before help could arrive. He was eventually caught and hanged.The old wreck was found in 1963 and
many artefacts recovered.Though Cornelisz had little time for practice, he can be seen as Australia's first doctor.
Résumé
En 1629, la "Batavia", le vaisseau amiral de la Compagnie des Indes Orientales, s'échouait sur une côte qui est
maintenant celle de l'Australie occidentale. Parmi les survivants du naufrage, se trouvait un pharmacien hollandais,du
nom de Jérôme Cornélius. A bord, ce dernier prit la commande du bateau quand le capitaine était occupé à naviguer
pour rejoindre le port et demander de l'aide. Cornélius se trouva ainsi à la tête d'une sanglante mutinerie au cours
de laquelle la plupart des naufragés furent massacrés, avant même l'arrivée des secours. Le chef mutin fut finalement
attrapé et pendu. En 1963, l'épave du vaisseau échoué a été retrouvée et de nombreux objets y ont étés récupérés.
Bien que Cornélius eût bien peu de temps pour pratiquer, il est considéré aujourd'hui comme le premier docteur
d'Australie.
The 'Batavia,' an apothecary, his mutiny and its vengeance.Vesalius, IX, 2, 22-24, 2003
officials, and two women and a baby, 47 in all. Leaving no senior people behind seemed a gung-ho decision and was to have fatal consequences.
At least, in common with a number of other well known navigational feats of the days of sail, they made a dead reckoning and covered the 2500 kilometres in 29 days with no loss of life. On reaching his destination, Pelsaert gathered a rescue crew and several soldiers and set sail back again in the Zaardam on July 15th. By coincidence, this ship had been in the original fleet, but had become separated in a storm and had made it safely to Batavia.
Meanwhile back at the Beacon Island there were about 250 people, who had initially enough water for two days. Luckily it rained heavily the next day and they were never short of water throughout the ensuing four-month ordeal. Even so 20 died from illness or drinking seawater.
As the most senior man left behind by the trusting Pelsaert, former apothecary Cornelisz took command and rallying his old conspirators, planned to take any rescue ship which might appear and use it for piracy.To facilitate this he further resolved to put into effect the scheme which was to propel him into history - to kill all those he considered useless or uncooperative, which meant of course most of the women and children. He persuaded Corporal Wiebbe Hayes and 46 of the soldiers not privy to his dastardly plan to go to look for water on an outlying island. In their absence, Cornelisz's villains, joyously and incredibly, slaughtered 125 of the remaining passengers and crew.
At first it was done by stealth at night with a sword, followed by a hurried burial in a shallow grave. Some were drowned, but soon any pretence of secrecy was abandoned and people were cut down as they fled in broad daylight.Their terror scarcely bears thinking of, for in truth they had nowhere to flee.
One young man,Andries deVries, pleaded for his life, so to earn this he was allocated the task of cutting the throats of twenty people in the sick tent. He complied, but it was to no avail as later he was chased across the beach and hacked to death. His skeletal body, cutlass wounds, dislocated jaw and all, has since been identified and is preserved in the Batavia exhibition of the Maritime Museum in Fremantle.
Cornelisz himself was careful to avoid actually bloodying his hands. For one thing he was of a cowardly nature, and second, just in case things went wrong, he wanted to appear in at least a reasonable light. Lastly, at least I like to think so, he was a medical man.
Several did manage to escape to join the soldiers and Hayes to help build a small fortress on what became
known as Wiebbe Hayes Island, now West Wallabi, the largest of the Abrolhos group. The ruined walls of this unique structure still stand as the oldest building of European origin, possibly of any origin, in Australia. Nearby, they assembled a fireplace to be used to signal to those on the main island if water was found. It was, but the smoke plumes were never answered, a negative response which aroused Hayes's suspicions.
Their fears were well founded and they came under attack.They twice beat off the mutineers and Cornelisz was actually captured during the second raid. If Hayes had despatched Cornelisz then, things would have worked out differently.
Meanwhile back on the Zaardem, after several lamentable navigational errors led to wandering among the reefs for over a month, after 63 days the rescue craft at last arrived, just in time to thwart a third attack by the rebels. They quickly saw the game was up and surrendered without a shot being fired.
Jeronimus Cornelisz was bound and brought aboard to face Commander Pelsaert. He tried to blame others for the mutiny, but was taken away to a specially built cell at the tip of the wreck island, Batavia's Graveyard.
Under contemporary Dutch Law if guilt was presumed then a prisoner could be tortured until he confessed. Jeronimus was duly tortured five times, each time retracting his confession when the agony ceased. When eventually the commander thought enough was enough, he was found guilty and condemned to have both hands cut off and then hanged. Other conspirators were more fortunate - they were to have only one hand cut off before hanging. The degree of degradation is moot, but apparently death alone was considered to be too good.
Cornelisz made several attempts to cheat the rope, including, at the very end use of his apothecary skills, an art he had sadly neglected over the recent past. It seems that he had secreted some poison about his person which he now took by mouth.We do not know what it was, but unfortunately for him it was ineffective. All it caused was severe abdominal pain.
With the acute symptoms, Cornelisz must have thought that hanging was the lesser evil, for he asked for some theriac or Venetian treacle, a treatment originally devised in classical times as a universal antidote and which by the 17th century was a compound of many drugs. Doubtless it was a therapy with which the victim was familiar. It worked, but not before he was recorded as having been up twenty times in the night with diarrhoea and vomiting. As Pelsaert noted in his report 'his so called miracle was working from below as well as above.'(2)
23
T h e 'Batavia , ' an a p o t h e c a r y , his m u t i n y a n d its v e n g e a n c e , Vesal ius, I X , 2 , 2 2 - 2 4 , 2003
And so on Oc tobe r 2 1629, seven mutineers were
hanged on the adjacent Seal Island, Cornel isz going first,
minus both hands and shouting 'Revenge! Revenge!' as
the noose t ightened. As a chilling warning to the like
minded, the bodies were left to hang unti l the weather
and t ime did the i r stuff.
Two others had the i r death sentence commuted , but
were abandoned on the mainland where Por t Gregory
is today.They disappeared w i t h o u t t race, which is a pity
as they wou ld have been the f i rst Europeans to have
dwel t on the Austral ian cont inent itself.
Six weeks later the Zaardem sailed fo r home, carrying
most of the Batavia's t reasure and a gig full of pr isoners.
Ten of the twelve treasure chests were recovered, one
was split open and the contents scattered and one was
jammed fast. These and many spilled artefacts such as
ceramics, si lverware and cannons were left as wel l as of
course the wreck itself.
The curtain on the drama finally came down over 300
years later. Following a t ip off by a resident f isherman on
Beacon Island, the site of the w reck was found in 1962
by Max Cramer of Gera ld ton, the mainland communi ty
opposite the Abro lhos Islands. Cramer w h o was looking
for the wreck anyway, was to ld that if all that he and his
team wanted was the odd skeleton, there was one under
the clothes line of another local f isherman, David
Johnson.
Cramer and his companions sought Johnson out , and
whi le look ing at this amazing exhibi t , he casually
ment ioned to the searchers that there were at least 10
more sets of bones under his hut. Having shown these
to the incredulous Cramer, the f isherman also led the
search party to where he thought the Batavia w reck was
situated. It was, and Max Cramer retr ieved a few
artefacts which clinched the identity. He and others
returned to salvage more , as wel l as what was left of the
old wooden boat i tself.The rest, as they say, is history.
I f you go today to the Fremantle Mar i t ime Museum,
you wi l l see many of these artefacts, including the now
preserved wooden side of the retr ieved Batavia, plus the
skeleton of the terr i f ied deVr ies , the t rust ing young man
w h o had been muti lated and hacked to death. In the
la t ter 1990s, a replica of the Du tch boat was
constructed in Fremantle and sailed to Hol land and
several European por ts to remind us of the mutiny and
the part played by the infamous apothecary, Jeronimus
Cornel isz, Australia's f i rst doctor.
References
1. JacobTVel l iosJ Southland.The Mari t ime Exploration
of Austral ia. Perth Min of Education Wes t Aust, 1987.
2. Edwards H Islands of Angry Ghosts. Hodder and
Stoughton, 1966.
3. Godard P The First and Last Voyage of the Batavia.
Abro lhos Publishing, 1993.
The material was originally presented as a paper to the
Austral ian Society for the His tory of Medicine at a
meeting in Darwin in 1995.
A u t h o r
James LeaveslyAM MB ChB (Liverpool) M.Phil. FRACGP.
PO Box 1553, Margaret River, Weste rn Austral ia 6285.
24
Louis X I V e t l e quinquina,Vesal ius , I X , 2 , 2 5 - 3 0 , 2 0 0 3
Louis XIV et le quinquina
Stanis Ferez
L'histoire de la santé du roi a été peu étudiée malgré
la richesse et la diversité des témoignages.1 Parmi la
pléthore des anecdotes médicales le concernant, on
peut discerner l 'apparition de l'usage du quinquina à la
Cour. Sans réécr i re l 'histoire du quinquina, surnommé
longtemps « poudre des Jésuites », on insistera sur
quelques épisodes retraçant sa diffusion à la C o u r de
Versailles, à la fin du Grand Siècle. Il s'agira de voi r
c o m m e n t et dans quel con tex te s'est dérou lée
l'utilisation du remède par un roi don t la santé exigeait
l 'emploi de remèdes fiables.
Ramenée du Pérou, à l 'extrême fin du XVIe siècle, par
des Jésuites ayant soigné avec succès la comtesse
Chinchon, l 'écorce t rouve sa place dans la liste des
remèdes végétaux, réputés efficaces. Circulant d'Espagne
en Angleterre, via l'Italie et les Flandres, le quinquina
acquiert, peu à peu, bonne presse chez les médecins et
leurs patients.2 Très vite, les puissants y on t recours, à
l'exemple de la vice-reine du Pérou. Dans la France de la
première moit ié XVIIe siècle, Gui Patin y fait plusieurs
fois allusion, de manière cr i t ique, dans ses Lettres.3 On
reproche alors à la poudre des Jésuites d'être f o r t
onéreuse, quarante livres la prise, dit le même Patin,4 et
de n'avoir pas d'effet vra iment satisfaisant. Dès lors,
seule une util isation à la C o u r donnerai t une nouvelle
réputat ion au remède.
Malgré ses détracteurs, nombreux sont les médecins
français de la seconde moi t ié du XVI Ie siècle qui
considèrent que le quinquina assure la guérison des
redoutables fièvres in termi t ten tes . Ces pathologies
étaient occasionnées par les eaux stagnantes des marais
omniprésents dans les campagnes d'alors, les courtisans
de Versailles n'étant pas plus épargnés. Néanmoins, des
doutes pers istent , c o m m e de cou tume , avec les
nouveautés.5 Chaque innovation est l'occasion de débats
voire de polémiques virulentes au sein de la profession
médicale, se prolongeant des décennies. Il en fut ainsi de
la querelle de l 'antimoine, f inalement t ranchée par un
vote du Parlement de Paris. L'exemple du ro i , guéri in
extremis en 1658 par le vin émét ique, garantit la v icto i re
des partisans du remède «chymique».6
Si le roi consent, en personne, à employer un nouveau
remède, en cas d'effet salutaire, celui-ci a toutes les
chances de devenir à la mode, au moins à la Cour, dans
un premier temps. Pour le reste de la populat ion, les
choses sont plus difficiles à quantif ier et les sources
concernant la diffusion des remèdes manquent , à
l 'exclusion tou te fo i s des pharmacopées et autres
ouvrages spécialisés. L'histoire de la circulat ion des
produi ts pharmaceutiques dans les sociétés de l 'Ancien
Régime en est encore à ses débuts.
C'est en 1680 que le t rès controversé Nicolas de
Blégny7 rend compte de l'usage du quinquina à la Cour,
même si, à cette date, le roi n'en a pas encore pris lui-
même.8 On parle alors du «remède du médecin anglais»
qui n'est autre qu'une préparat ion du quinquina, en
part icul ier dans du vin, comme on va le voir, plus loin, en
détail. Le fait que Louvois, la duchesse de Bourbon et le
duc du Maine aient eu recours à ce remède garantit sa
renommée et sa diffusion dans l 'aristocratie, au moins en
tant que sujet de conversation.9 Toujours en 1680,
Madame de Sévigné signale que « l ' inventeur » du
remède miracle cont re les fièvres, Rober t Talbot, a fait sa
démonstra t ion en présence du ro i , lors de la maladie du
Dauphin. Privilège de taille qui s'explique par l 'heureux
succès de la po t ion sur la Dauphine el le-même et sur le
roi Charles II d 'Angleterre, aux dires de Talbot . Elle
rappor te l 'événement avec l ' ironie qu 'on lui connaît :
25
Résumé On dispose de renseignements précis sur l'usage du quinquina par Louis X I V à l'occasion de plusieurs fièvres
survenues dans les années 1680-1700. La « querelle du quinquina » oppose Rober t Talbot, médecin anglais, à Nicolas
de Blégny, empir ique proche de Daquin, premier médecin du ro i . L'utilisation du quinquina par Louis XIV, vérifiable
notamment grâce au Journal de Santé, est aussi ment ionnée dans plusieurs publications médicales. L'exemple royal,
référence pour bien des courtisans, offre l'occasion d'analyser le processus de diffusion du remède dans la haute
société. Dès que Louis X IV utilise le quinquina, le remède se banalise et entre, alors défini t ivement, dans les
pharmacopées.
Summary A detailed account is given of the use of quinine by Louis XIV, while suffering from fevers during the period from
1680-1700. On opposing sides in the'Quinine feud' (querelle du quinquina) were Robert Talbot, an English physician, and Nicolas de Blegny, a famous quack who was a friend of Daquin, the king's senior physician. The use of quinine by Louis XIV was reported in the 'Journal de Sante' and was also noted in many other medical publications. The royal use set an example for many of the court, and offers a chance to examine the spread of the use of quinine into the aristocracy. Once quinine had been used by the king, the remedy became accepted and was specified in the pharmacopoeias.
Louis X I V e t l e quinquina,Vesal ius , I X , 2 , 2 5 - 3 0 , 2 0 0 3
«C'est dommage que Mol ière soit m o r t ; i l ferait une
scène merveil leuse de Daquin, qui est enragé de n'avoir
pas le bon remède, et de tous les autres médecins, qui
sont accablés par les expériences, par les succès, et par
les prophéties comme divines de ce pet i t homme. Le Roi
lui a fait composer son remède devant lui, et lui confie la
santé de Mgr. Pour Mme la Dauphine,el le est déjà mieux,
et le comte de G r a m o n t disait hier au nez de Daquin :
«Talbot est vainqueur du trépas ;
Daquin ne lui résiste pas ;
La dauphine est convalescente :
Q u e chacun chante, e t c . . . " »
Talbot communique plus tard le détail de sa prétendue
découverte au premier médecin du ro i , An to ine Daquin,
et à Fagon, alors médecin du duc de Bourgogne et des
Enfants de France, en présence de Co lber t . Le remède
fait bénéficier son « inventeur » d'une gratif ication
conséquente.1 2 En quo i consistai t l ' innovat ion du
médecin anglais ? En une préparat ion assez rudimentaire
précisant la quanti té de quinquina par pinte de vin et des
prises espacées de deux heures, plusieurs fois par jour.
Talbot estime que huit onces pourra ient venir à bout de
tou te f ièvre.
Une autre publ icat ion, due à Monginot , parue en 1680
encore, avance le chiffre d'une once ou d'une once et
demie par prise, pour vaincre la f ièvre, soit quatre à six
onces au to ta l , dans quatre fois plus de vin. Ceci
cor respond, plus ou moins, au dosage conseillé par
Talbot, la pet i te différence dissuadant, par la même
occasion, de cr ier immédiatement au plagiat pur et
simple.
Le « nouveau » remède fait parler de lui et passionne
l'élite cult ivée. On aborde le sujet dans les salons, d'où
le célèbre Poème sur le quinquina de La Fontaine, ami de
Monginot , dédié à la duchesse de Bouil lon :
«. . . Ce dieu (Apollon), dis-je, touché de l'humaine misère,
Produisit un remède au plus grand de nos maux :
C'est l 'écorce du kin, seconde panacée
(...) Nul le l iqueur au quina n'est contra i re :
L'onde insipide et la cervoise amère,
Tout s'en imbibe ; il nous permet d'usé
D'une boisson en ptisanne apprêtée.»13
La même année, en 1682, Blégny prolonge son attaque
cont re Talbot dans Le Remède anglois pour la guérison des
fièvres avec les observations de M. le premier Médecin de S.
M.14 Daquin est un allié de poids. Il sert autant de garant
scientifique que de témoin de moral i té à celui qui est
conspué par la Faculté. Il est intéressant de noter ce
qu'en dit le Journal des sçavans: « Enfin grâces à la bonté
du Roy et aux soins de M. Daquin, son premier Médecin,
nous ne devons plus craindre d'estre vainement flatez de
la nouvelle Découver te du remède Anglois ».15
La publication de Blégny rejette l'idée selon laquelle le
remède serait nouveau. Au passage, elle en modif ie la
préparat ion : il faut laisser le quinquina infuser plus
longtemps et on ne saurait le prescrire en cas de fièvre
causée par des « dévoyemens excitez par l ' intempérie
des viscères et l ' i r r i tat ion d'une bile répandue ». Il ne
faut pas non plus nour r i r le patient immédiatement
après le t ra i tement .
Peut-on vraiment parler d' innovation ? N o n , si l'on se
plonge dans les documents conservés par le docteur
Vallant, médecin de Madame de Sablé puis de
Mademoiselle de Guise.16 Le praticien note, dans ses
papiers, la guérison d'une fièvre au moyen d'une infusion
de quinquina dans du vin blanc. Or, cette ment ion nous
ramène au mois de juin 1669, bien avant l 'expérience du
médecin anglais.17
Tout le mér i te de la mise en évidence de la petite
supercherie de Talbot rejaillit sur le premier médecin.18
On constate que la « querelle du quinquina », si
l 'expression n'est pas exagérée, concerne
essentiel lement des courtisans ambit ieux, souhaitant
avoir la p r imeur d'une découverte déjà ancienne ! Si
nouveauté il y a, elle consiste sur tou t dans l'ampleur de
sa diffusion à la C o u r : elle atteint le roi en personne.
Con t ra i rement à certains de leurs confrères, ni Blégny, ni
Daquin, ne songent vraiment aux malades les plus
modestes. C'est l'une des étrangetés de la médecine du
Grand Siècle que de fe rmer les yeux sur l'exécrable
santé de la populat ion, avec une indifférence tou te
ar istocrat ique et ce, malgré les ponctuelles Médecine des
pauvres et les quarantaines en cas d'épidémie. La poudre
fébrifuge est, par ailleurs, ex t rêmement onéreuse et la
seule r e n o m m é e scient i f ique i m p o r t e moins aux
médecins qu'une belle pension et, pourquoi pas, un
privilège royal pour sa préparat ion. '9
En 1686, un opuscule int i tulé Manière de se servir du
kinkina, et, sans doute, de la main de Fagon, conseille la
prise avec du vin de Bourgogne : c'est l'un des premiers
avatars de la célèbre querelle Bourgogne-Champagne
dans laquelle le roi aura prise, du fait du régime imposé
par celui qui sera b ientôt son premier médecin.20 Cet te
même année, celle de la fistule anale, Louis X IV est pris
de fièvres liées à son inf i rmité et do i t recour i r au
quinquina, de manière ponctuelle.21
Daquin précise, dans le Journal de la santé du roi, que le
monarque mange deux heures après la prise du remède.
L'âpreté du mélange laisse une sensation désagréable
dans la royale bouche mais l 'absorption de pâte de
groseille et d'écorce d'oranges du Portugal viennent
26
Louis X I V e t l e quinquina,Vesal ius , I X , 2 , 2 5 - 3 0 , 2 0 0 3
chasser cette amertume.22 Le tex te anonyme, attr ibuable
à Fagon, signalait un problème identique et conseillait,
pour sa part, l'usage de sirop d 'abr icot et de framboise.23
On pouvait aussi prendre le quinquina en bol , c'est-à-
dire en poudre non diluée et tamisée à travers un tissu
de soie, accommodée ensuite sous fo rme de pâte.
Curieusement, Daquin le déconseille dans son ouvrage
intitulé Secrets concernant la beauté, publication qui t i re à
boulets rouges sur Talbot , c o m m e l ' indique le
témoignage de Madame de Sévigné.24
Au début du mois de septembre 1687, le roi est
contraint à des prises toutes les quatre heures et ce,
même la n u i t , - on le réveille à cet effet ! — en raison de
fièvre, d'un refroidissement et de sueurs consécutives à
une saignée.25 Le nombre des prises s'élève à six au
début, puis leur nombre décroît. En 1688, Blégny, citant
Daquin, indique la valeur d'une livre d'écorce dans
quinze pintes de vin (une pinte équivaut environ à 0,93
litres) pour la première infusion, à raison d'un demi
setier (un setier équivaut à environ 7 litres) pour quatre
personnes. La quantité doi t être décroissante, au fur et à
mesure du t ra i tement.
Au mois d'avril 1688, Louis X IV reprend du quinquina
en pi lules d'une drachme chacune (une drachme
équivaut à environ 3,8 grammes). Elles s'accompagnent,
amertume oblige, de marmelade d'abricots. On a déjà
souligné le fait que le monarque souffre beaucoup du
goût repoussant du quinquina, d'autant que le piètre état
de sa dent i t ion en accroît sans doute la sensation.26
Le rappor t établi entre fébrifuge et saignée est
éclairant, à plus d'un t i t re , quant au t ra i tement reçu par
le ro i . En septembre 1687 et durant les fièvres
intermit tentes de juin 1688, l 'écorce est employée à
l'issue de saignées. Or, le lien entre les deux n'est pas
aussi évident qu'il y paraît de pr ime abord. On ne
donnait pas le fébrifuge systématiquement après les
saignées.Aucun tex te ne le stipule, de manière explicite.
La faiblesse consécutive à l 'opérat ion explique peut-être
l'usage du quinquina. Par cont re, l'usage de lavements et
de purgations préalables aux prises n'est pas exclu, à
l 'exemple des indicat ions contenues dans une
publication de I687.27 Plus loin, ce tex te parle à nouveau
du ro i , l ivrant au lecteur une descript ion aussi instructive
qu'étonnante de précision :
«La pluspart des Seigneurs de la Cour, et de ceux qui
ont été malades à Paris, n'avoient voulu suivre d'autre
méthode jusques à présent, que celle de l'Anglois,
comme la plus assurée mais comme dans les derniers
accès de fièvre que le Roy eut à Versailles au mois de Juin
1688 Sa Majesté pr i t du Kinkina en substance dans du
vin, et s'en t rouva parfaitement bien, puisque la fièvre
quitta à l'instant (...).
Le Roy a pris le kinkina en substance dans du vin,
c'est-à-dire une dragme de poudre rédui te en A l kôo l sur
le porph i re dans un verre d'environ six onces d'infusion
ordinaire du Kinkina, le soir et le matin pendant huit
jours, ensuite une fois le matin pendant quinze jours, et
enfin la même dose pendant t ro is semaines partagées
par autant de semaines de repos, sans y prendre aucun
remède. Il en a été parfai tement guéri , sans être
incommodé de la moindre chaleur».28
L'auteur a-t-il connu le premier médecin d'alors ou
ceux servant le roi « par quar t ier »? En t o u t cas, la santé
du roi n'est pas, le moins du monde, un secret d'Etat.
Bien au contra i re , on utilise son exemple pour garantir
l'efficacité du remède et f ixer sa posologie. L'usage du
remède par Louis X I V aurai t - i l servi d 'a rgument
publicitaire? Ce n'est pas impossible. En t o u t cas, les
informat ions sur la préparat ion du « kinkina » du roi
pallient les silences du Journal de Santé. Daquin n'a pas
jugé bon de consigner les détails de sa préparat ion, peut-
être parce que la formule était connue de t o u t le monde
par le biais des publications qui se mult ipl iaient, au sujet
de la précieuse écorce péruvienne. Inutile de signaler
dans le Journal une in format ion connue de tous. Ce détail
aurait pour tan t garanti la véracité des indications livrées
au public.
Tous les auteurs considèrent que le quinquina est en
soi un purgatif qui ne to lè re pas l 'encombrement des
intestins. Dangeau note d'ailleurs que le quinquina purge
le roi et Daquin souligne, à nouveau, les appréhensions
du ro i , le médecin chassant, cet te fois-ci, l 'amertume par
l 'adjonction d'eau de f leur d'oranger.29 Les médecins
changent leur f o rmu le pou r a t ténuer le goû t du
médicament mais le patient demeure insatisfait. Il est
f o r t possible que le dégoût quasiment définit if du ro i
pour le quinquina le contraigne à recour i r aux saignées
qu'il a longtemps abhorrées.30
On a re t rouvé un témoignage assez laconique,
émanant du roi lu i -même sur l 'emploi du quinquina.
Dans une let t re adressée au Dauphin, en juin 1694, Louis
X I V confie : « La f ièvre m'a pris hier sur les t ro is heures
après midi ; l'accès m'a duré neuf heures. Je suis sans
fièvre présentement, et j'ai pris du quinquina, que
j 'espère qui l 'empêchera de revenir ».31 Le roi fut exaucé
mais il semble, au regard des sources, que ce fut sa
dernière prise de quinquina. Cer tes, le journal est
demeuré inachevé, subi tement in te r rompu en 1711
mais, même au cours de la décennie 1700-1710, les
ment ions de l 'écorce se fon t rares dans la pharmacopée
du premier médecin. Ni Dangeau, ni Sourches n'en
parlent plus à cette époque, sans doute en raison de la
consommat ion croissante du remède, donc d'une
certaine banalisation.
27
Louis X I V e t l e quinquina ,Vesal ius , I X , 2 , 2 5 - 3 0 , 2 0 0 3
Les courtisans on t vulgarisé le médicament, au moins
par mimét isme à l'égard du roi . Racine ne dit pas autre
chose, écrivant à Boileau en août 1687 qu'on ne voi t à la
C o u r que des gens qui on t le ventre plein de quinquina.32
Chacun singe un peu le ro i , l'usage du fébri fuge
instaurant une sor te d'égalité de façade avec le ro i , au
niveau des soins. On peut ainsi se vanter d 'être soigné
comme Louis XIV, lu i-même, l'avait été. Il n'en faut pas
davantage à certains. D'autres enfin, restent impassibles,
à l 'exemple d'un Saint-Simon, d'ai l leurs peu
enthousiasmé par le quinquina.33 Mais la conjugaison des
deux facteurs est indéniable, les courtisans veulent t o u t
s implement prof i ter de remèdes vra iment efficaces
con t re les f ièvres paludéennes qui empestent les
environs marécageux de Versailles.34
Curieusement, pour tant , les pharmacopées officielles
n 'accorderont pas au quinquina la place qu'on cro i ra i t
devoir lui être at t r ibuée. Le remède figure effectivement
dans la Pharmacopée universelle de Nicolas Lemery mais,
de manière p lu tô t discrète. Pas de trace du « kinkina »
dans l'index, oublié aussi par Moyse Charas. Il faut aller
chercher à l 'article « Vinum febrifugum » pour rencont rer
une allusion à l'écorce.35 Cet te place tou te modeste
renvoie sans doute aux réticences de ce défenseur de la
médecine chimique qu'est Lemery. A u x yeux de bien
des lecteurs, le quinquina ne const i tuerai t qu'un remède
parmi des mill iers d'autres si le nom de Louis X I V n'y
était impl ic i tement associé.
L'étude de l'usage d'une substance médicamenteuse
par un souverain peut être d'un in térêt majeur pour
l 'histoire de la consommat ion, de la prescr ipt ion et de la
diffusion d'un nouveau t ra i tement . Il est certain que le
quinquina a permis à Louis X I V d'atténuer l ' intensité,
sinon la durée, de ses fièvres. C'est, à n'en pas douter,
l'un des meil leurs remèdes qu'on lui ait prescri t . Et
pour tan t , son amer tume l'a fait rejeter. Ce t effet
indésirable incommodai t le ro i , comme bien d'autres,36
jusqu'à lui faire préférer, par défaut, la t radi t ionnel le
saignée. Le rôle du premier médecin est difficile à
évaluer mais, défenseur de sa rece t te , il ne put
logiquement dissuader le roi d'y recourir . La vo lonté
royale aura t ranché en sa défaveur.
Le quinquina est utilisé, dès le début du XVI Ie siècle,
donc bien avant Talbot, dans des préparations plus ou
moins hasardeuses, destinées aux patients de médecins
préférant recour i r à la « poudre des Jésuites » p lu tô t
qu'à la purge ou à la saignée systématique. Il faudra
at tendre un peu, avant qu'il n'atteigne la famille royale. Il
convient , au préalable, de connaî t re plusieurs cas
indiscutables de guérisons attr ibuées au remède pour
que le roi consente enfin à l 'expér imenter sur lu i -même.
C'est la première phase, disons ascendante. Une fois que
le roi en use en personne, il y a re tour de balancier :
l 'écorce infusée devient à la mode, sur tout à la cour et,
son efficacité avérée confère à sa diffusion un second
souffle. On entre alors dans la phase descendante qui
about i t , quelques années après, à une diffusion encore
plus large. Celle-ci s'effectue par l ' intermédiaire des
ouvrages médicaux vantant l 'exemple royal et des
officines d'apothicaires, augmentant leurs ventes. Le roi
occupe, par conséquent, une place charnière dans cette
di f fusion puisqu' i l a lu i -même expér imen té l'effet
salutaire du remède. Sa santé a servi de référence,
comme dans le cas de l 'antimoine, à l'issue de sa maladie
de 1658.
Des études complémenta i res pe rmet t ra ien t
d'augmenter et de clarifier not re connaissance de la
diffusion sociale des substances et des pratiques de
santé, au XVIIe siècle. La place du roi dans ces processus
complexes gagnerait, elle aussi, à être précisée, à part i r
d 'autres prob lémat iques tant médicales que bio
historiques.
N o t e s
1 Signalons deux études synthétiques, celles de E.
Deguéret, Histoire médicale du Grand Roi (Paris, M.
Vigne, 1924), et celle, plus récente, de C. D. O'Malley,
« The Médical H is tory of Louis X IV : Intimations of
Mor ta l i ty » dans Louis XIV and the Craft ofKingship (J.
C. Rule (dir.), O h i o University Press, 1969).
2 Sur la diffusion du quinquina : P. Delaveau, Histoire et
renouveau des plantes médicinales, Paris, Albin Michel,
1982 ; G. Penso, Les Plantes médicinales dans l'art et
l'histoire (1904), rééd., Paris, R. Dacosta, 1986 ; M.
A lbou « L'histoire du quinquina », Gazette médicale,
18,98, 17-23 mai 1991.
3 Le problème du quinquina, à cette époque, est qu'il
s'évente en perdant une part ie de ses qualités. Patin
y voi t de quoi le discréditer : Lettres, J. H. Reveillé-
Parise (éd.), Paris, J.-B. Baillière, 1846, lettres du 30
décembre 1653 (III, p. 19), 30 janvier 1654 (II, p. 107),
13 novembre 1654 (II, p. I 12).
4 Somme considérable puisque, en 1648, un
apothicaire du Grand Condé reçoit , annuellement,
50 livres de gages !
5 Un dénommé Lheri t ier soutient, en 1667, une thèse
sur le sujet suivant: An febri quartanae cortex cynoe
cynoe specificum. Voir O. Guel l iot , Les Thèses de
l'ancienne Faculté de Médecine de Reims, Reims, F.
Michaud, 1889, n° I 16.
6 Sur cet te querelle autour d'un remède longtemps
considéré comme un poison, voir : Etienne Krieger,
Une Grande querelle médicale. Histoire thérapeutique de
l'antimoine, Paris, Carré et Naud, 1898 et Pascal
Pilpoul, La Querelle de l'antimoine, Paris, L. Arne t te ,
1929.
28
Louis X I V e t l e quinquina,Vesal ius , I X , 2 , 2 5 - 3 0 , 2 0 0 3
7 Nicolas de Blégny, né à Paris vers 1652, s'i l lustre par
la créat ion, chez lui, d'une Académie des nouvelles
découvertes don t les résultats des expériences sont
publiés à A m s t e r d a m . B ien tô t décr iée par les
membres de la Faculté à laquelle il n'appart ient pas,
malgré l'appui du premier médecin, Daquin, Blégny
est envoyé à la Bastille, de manière brève, en 1686,
pour contrefaçon de remède. Il doi t , plus ta rd ,
s'exiler après un autre séjour en pr ison, en 1693, lié
à l 'ouverture d'un hospice sans autor isat ion. La date
de sa m o r t est inconnue.
8 N. de Blégny, La Découverte de l'admirable remède
anglois pour la guérison des fièvres, Paris,
Blageart /D'Houry, 1680. Con tempora in de cet te
publication, un autre tex te , consacré au même sujet,
a pu l'inspirer. Il s'agit du t ra i té de Monginot , De la
guérison des fièvres par le Quinquina, Lyon/Paris, R.
Guignard, 1679 (édit ion supplémentaire en 1680).
9 « Les Remèdes que donne le Médecin Anglois pour
les Fièvres i n te rm i t ten tes , se sont t rouvez
merve i l leux. Mademoisel le , Mr. L'Evesque de
C o n d o n , Mons ieur le Premier Président, et
beaucoup d'autres Personnes de marque, s'en sont
servis très ut i lement et on ne sçauroit t r o p vanter
après des cures si considérables » : Mercure galant,
septembre 1678, p. 243-244.
10 Sur ce médecin d'origine anglaise don t le vrai nom
serait « Tabor », on dispose de peu d' informations.
Ar r i vé en France à une date inconnue, on sait qu'i l
est à Paris au milieu de l'année 1678. On lui connaît
un t ra i té int i tulé : Pyretologia, or a Rational Account of
the Cause and Cure ofAgues, with their Signs, Londres,
1672. Malgré le t i t re de « chevalier » que lui at t r ibue
Mme de Sévigné, son anobl issement n'est pas
certain.
I I Mme de Sévigné, Correspondance, Paris, Gal l imard, La
Pléiade, let t re du 8 novembre 1680 à Mme de
Grignan, p. 56. Bizarrement, la marquise ne di t m o t
de sa propre expér imentat ion du quinquina dans
cette let t re.
12 Archives nationales (désormais A N ) , O9 24. Le 13
novembre 1680, est signalée une rente de 2.000
livres au prof i t de Talbot. A t i t re de comparaison, la
même pension est at t r ibuée à Cornei l le , en 1665.
C'est une somme considérable.Voir : les Comptes des
Bâtiments du roi sous le règne de Louis XIV, J. Guiffrey
(publ.), Paris, Impr imer ie nationale, 1881,1, p. I 12.
13 Chant I et II.
14 Publié à Paris chez l'auteur, sans privilège, en 1682.
15 Journal des sçavans, XV, lundi 8 juin 1682, p. 171.
16 Sur cet intéressant médecin, voir .T étude de Joseph
Georges André Crussaire, Un Médecin du XVIIe siècle,
le docteur Vallant. Une malade imaginaire. Mme de
Sablé, Paris,Vigot frères, 1910.
17 BnF :Ms Fr. 17053, Portefeuil le de Vallant, fo l . 104.
18 « M. d 'Aquin pour reparer toutes ces fautes prescri t
la véri table manière don t on se do i t servir de ce
remède, et qui en rend les effets infaillibles » : op. cit.,
p. 175.
19 C'est ainsi qu 'Adr ien Helvétius en obt ient un pour le
remède à base d'ipécacuana qui po r te ra son nom et
qui sera expédié à toutes les généralités du royaume,
dans la première moi t ié du XVII Ie siècle ( A N , Z'B 95,
ff. 949-950). Au sujet du quinquina, le médecin
hollandais publie sa Manière de donner le quinquina
aux pauvres pour les guérir de toutes sortes de fièvres
intermittentes, opuscule de quatre pages, mont ran t sa
vo lon té d'en popular iser l'usage (Versailles, Fr.
Muguet, 1682).
20 Versailles, Fr. Muguet, sans date. Sur la querelle
opposant les partisans des deux vins pour des
raisons médicales, vo i r : Jean-Baptiste Salins, Défense
du vin de Bourgogne contre le vin de Champagne (...),
Paris, 1702 (autre édi t ion : Luxembourg, A. Chevalier,
1704) ; Eloges des vins de Bourgogne et de Champagne,
ou Deux odes latines (...), Paris,J. Estienne, 1712.
21 « Le Roy a eu un accez de seize heures ; il prendra
ce soir du quinquina. Priés Dieu qu'il bénisse les
remèdes », let t re de Mme de Maintenon à Mme de
Br inon , vers le 21 aoû t 1686, dans Mme de
Maintenon, Lettres, M. Langlois (éd.), Paris, Letouzey,
1935, II, le t t re 4 6 1 . Uti l isat ion du quinquina par le roi
de France qui est connue à l 'étranger par le biais de
l'Histoire abrégée de l'Europe, gazette paraissant à
Leyde (chez Cl . Jordan, 1686, septembre, p. 256).
22 A.Val lot ,A. Daquin, G.-C. Fagon,Journal de la santé du
roi Louis XIV,}. Le Roi (publ.), Paris, Durand, 1862, p.
173 (désormais JS). Réédit ion à paraître, en 2004,
aux édit ions Jérôme Mi l lon, Grenoble.
23 Op. cit., p. 3.
24 ( N . de Blégny), Secrets concernant la beauté et la santé,
recueillis et publiez par ordre de Monsieur Daquin, Cr du
Roy en ses Conseils, et premier médecin de S. M., Paris,
L. d 'Houry /Veuve D. N i o n , 1688, p. 28. No tons que
l'auteur précise que les informat ions concernant le
quinquina sont t i rées des « règles t i rées des
Mémoires de Mr le Pr. Médecin du roy, touchant
l'usage de cet te premier infusion » (p. 18). « Le plus
grand secret de la pluspart des Empirics ne consiste
que dans le déguisement des Drogues qu'ils met tent
en usage ; car comme ce sont tou jours celles mêmes
don t les Médecins connoissoient la nature et les
propr ietez, ils ne pour ra ien t les faires passer pour
des Remèdes secrets, s'ils n'affectoient de leur
29
Louis X I V e t l e quinquina ,Vesal ius , I X , 2 , 2 5 - 3 0 , 2 0 0 3
donner un air de nouveauté, c'est ainsi qu'en a usé le
SrTalbotdans la préparat ion du Quinquina (...) » (p.
26).
25 JS, p. 182. Dangeau ment ionne l'usage du quinquina
par le roi seulement à par t i r du 17 novembre: « Le
roi pr i t médecine, et le soir il repr i t du quinquina ; il
en prendra encore t ro is jours, comme il le fait
tou jours après avoir s'être purgé »,journal du marquis
de Dangeau, Soulié, Dussieux (publ.), Paris, F. D ido t ,
1855 (I), III, p. 67.
26 JS, p. 192. C'est sans doute ce qui le pousse à n'en pas
voulo i r prendre le 30 mai 1688, comme le suggère
Mme de Maintenon: Lettres, op. cit., le t t re 558.
27 Les Admirables qualitez du kinkina (...), Paris, M. J.,
1689, p. 5-6 : « C'a esté de ces raisons qui obligea de
faire saigner Sa majesté pour la f ièvre qu'elle eut en
l'année 1687, de luy donner des lavemens, et de ne
luy faire prendre le Kinkina qu'après le 3e accès
expiré ». L'ouvrage reçoi t les approbations de Le Bel
et Fagon.
28 Op. cit., p. 26-28. L'approbation de Fagon est datée de
janvier 1689, celle de Le Bel, premier médecin de
Monsieur et de Madame, est datée de février.
Dangeau note dans son Journal, à la date du 14 juin :
« Le roi a eu à Marly un (sic) accès de f ièvre de 26
heures chacun (sic) ; on a eu peur que les accès ne
se joignissent. On lui a donné du quinquina ; la f ièvre
n'est pas revenue, mais il lui reste de la foiblesse et
des vapeurs ». Le 4 jui l let, l 'auteur signale des prises
de quinquina une fois par j o u r seulement .
Respectivement, p. 147 et 151.
29 Au début du mois d 'août 1693, les f ièvres
in termi t tentes reviennent et le quinquina avec elles :
« Le quinquina le purge fo r t , et on regarde cela
comme un bon effet du remède ». Dangeau, op. cit.,
10 août 1693, p. 340 ; vo i r aussi : JS, p. 207.
30 Ainsi, au pr intemps 1696 :JS, p. 226 sq.
31 Louis XIV, Œuvres, Grouvel le (publ.), Paris, Treuttel
et W u r t z , 1806, IV, let t re du 8 juin 1694, p. 420. C'est
le marquis de Sourches qui nous conf i rme la
guérison du roi deux jours après : « le 10, qui é to i t
le jour de la fête du Saint-sacrement, le Roi n'alla pas
à la procession, quoiqu' i l n'eût plus de f ièvre (...) » :
Mémoires du marquis de Sourches, Cosnac (éd.), Paris,
Hachette, IV, p. 344. En avril, le roi avait déjà pris du
quinquina pour sa f ièvre (op. cit., p. 322 sq.).
32 « Quant i té de gens de mes amis sont malades, entre
autres M. le duc de Chevreuse et M. de Chamlai :
tous deux on t la f ièvre double-t ierce, M. de Chamlai
a déjà pris le quinquina ; M. de Chevreuse le prendra
au premier jour. On ne voi t à la cour que des gens
qui on t le ventre plein de quinquina. Si cela ne vous
excite pas à y venir, je ne sais plus ce qui peut vous
en donner envie » : let t re du 17 août 1687, Œuvres
de Jean Racine, Paris, Lefèvre, 1833, let t re X I I , p. 465.
33 Saint-Simon, Mémoires, G.Truc (éd.), Paris, Gall imard,
La Pléiade, 1953, II, p. 914.
34 Voir : J.-A. Le Roi, Des Eaux de Versailles, considérées
dans leurs rapports historique et hygiénique, Versailles,
Despart , 1847.
35 N. Lemery, Pharmacopée universelle, Paris, L. D'Houry,
1698, p. I 39. A cette époque, on suggère comme
posologie des prises toutes les quatre heures, durant
quinze jours. L'auteur conseille aussi d'être purgé,
vo i re saigné, avant la prise parce que le quinquina
« fixe les humeurs » (p. 140).
36 Voir la Méthode pour guérir toute sorte de fièvres sans
rien faire prendre par la bouche. Découverte et donne au
Roy par le Sr Helvetius, Paris, Veuve N. Oudo t , 1694,
no tamment p. 5-6
N o t i c e b iograph ique
Stanis Ferez. Professeur d'histoire au lycée Charles de
Gaulle de Longperr ier (France), doc torant à l'Ecole des
Hautes Etudes en Sciences Sociales (EHESS) (Paris)
préparant une thèse sur la santé de Louis XIV, sous la
d i rect ion de Jacques Revel. Assure la réédit ion du journal
de la santé de Louis XIV aux éditions Jérôme Mil lon
(Grenoble) .
30
C a r t é s i a n i s m e et c i rcu la t ion sanguine, Vesalius, I X , 2 , 3 I - 3 4 , 2003
Cartésianisme et circulation sanguine
Jean Jacques Peumery
Philosophe, mathématicien et homme de science
français, René Descartes fut l ' initiateur des idées et des
méthodes qui on t net tement différencié les temps
modernes de la pér iode médiévale.
Né à La Haye en Touraine, le 3 I mars 1596, il mou ru t
à Stockholm, le I I février 1650.
Sa doc t r i ne ph i losoph ique, appelée depuis le
"cartésianisme", était fondée sur un rationalisme et un
matérialisme mécaniste et même métaphysique.
Son " Discours de la Méthode " a pu être divisé en six
parties. C'est en la cinquième qu'il donne l 'explication du
mouvement du coeur - con formément à sa doct r ine et
de quelques autres questions qui appart iennent à la
médecine. Il en déduit la différence qui semble exister
entre notre âme et celle des bêtes. Ce t ouvrage fut
publié à Leyde, en 1637, sans nom d'auteur, sous le t i t re :
Discours de la méthode pour bien conduire sa raison
et chercher la véri té dans les sciences ".(l)
Beaucoup plus tard , René Descartes écrivait un autre
trai té, le "De Homine" , qui parut posthume, et dans
lequel il s'élève cont re la concept ion des mouvements
du coeur décrits par Wi l l iam Harvey. Pour lui, le coeur
est le siège du feu et, ce feu ne ser t qu'à dilater, échauffer
et subtil iser le sang qui t ombe , gout te à gout te , par la
veine cave dans la concavité du coeur dro i t . Il est
probable que Descartes a écr i t cet ouvrage vers la fin de
sa vie. On reste, en effet, confondu devant les errements
d'un si génial penseur; aussi, ne prendrons-nous en
considérat ion que son "Discours de la méthode." (2 )
Exposé :
Descartes a décr i t les "chambres ou concavités" du
coeur. Dans la concavité dro i te s'abouchent "deux
tuyaux f o r t larges", la "veine cave", qui amène t o u t le
sang au coeur, et la "veine a r té r ieuse" (a r tè re
pulmonaire), qui a été mal nommée, parce que c'est en
réalité une ar tère qui, provenant du coeur, se divise en
deux branches qui distr ibuent le sang dans chaque
poumon.
A la cavité gauche répondent , de la même manière,
deux "tuyaux qui sont autant ou plus larges que les
précédents" : " l 'artère veineuse " (veine pulmonaire), qui
a aussi été mal nommée, car c'est en réalité une veine,
qui ramène au coeur le sang des poumons, où elle était
31
Résumé
C'est au médecin anglais, Wi l l i am Harvey, que revient le mér i te de la découverte de la circulat ion du sang, qu'il
expliqua dans son "De mo tu cordis", en 1628.
Cet te innovation dans l'art de la médecine suscita une campagne d'opposi t ion acharnée. Il se fo rma deux clans
opposés : les circulateurs et les anti-circulateurs. Cinquante années furent nécessaires pour assurer le t r i omphe des
circulateurs.
René Descartes (1596-1650) f i t cependant except ion ; il admetta i t certes la circulat ion sanguine tel le que l'avait
démontrée Harvey mais il réfutait la systole et la diastole, génératrices du mouvement circulatoire du sang. Selon sa
doctr ine, c'était la chaleur du coeur qui était la cause des battements cardiaques.
La doctr ine de Descartes -le "cartésianisme" -fit école. Près de cent ans plus tard , des médecins de renom
soutenaient encore la doctr ine cartésienne.
Il faudra attendre la seconde moi t ié du X I X e siècle pour que la vér i té sur le mouvement du coeur et la circulation
du sang, telle que nous la concevons aujourd'hui soit, une fois pour toutes, déf ini t ivement établie.
Summary
The English physician William Harvey (1578-1657) was the first to discover the mechanics of the circulation. In
1628, Harvey's greatest work 'Exercitatio anatomica de motu cordis et sanguinis in animalibus' was published in
Frankfurt. In this work, the author explained, with admirable clarity, observations he had made on the heart and blood
movement and the theory he had elaborated about the circulation of the blood.
Harvey's theory was so revolutionary that it induced bitter opposition. However, before he died, Harvey's findings
were completely acknowledged.
The French philosopher, mathematician and scientist, Rene Descartes (1596-1650), considered the circulation of
the blood in his'Discourse on Method'. He played a large part in encouraging acceptance of William Harvey's theory
of circulation, but he mistakenly thought that the heat of the heart was responsible for the generation of the
heartbeat.
Descartes' philosophy 'Cartesianism' had many adherents for a long time, almost a century later renowned
physicians such as Pierre Chirac and Raymond Vieussens still accepted the Cartesian doctrine.
It was not until the second half of the nineteenth century that the exact nature of heart action and blood circulation
were clearly and definitely established.
C a r t é s i a n i s m e e t c i rcu la t ion sanguine,Vesal ius, I X , 2 , 3 1 - 3 4 , 2 0 0 3
divisée en plusieurs rameaux ; et la " grande ar tère
( l 'aor te) qu i , so r t an t du coeur, envoie, par de
nombreuses artères, le sang dans t o u t le corps.
Les Anciens, expl ique Descartes, "on t cru que toutes
les veines venaient de la cavité dro i te du coeur, et toutes
les artères de la gauche".
Les branches de I "ar tère veineuse" sont entrelacées
avec celles "de ce condui t qu'on nommé le sifflet, par où
entre l'air de la respirat ion". C'est-à-dire le système
t rachéo-bronchique.
Descartes parle aussi des " onze petites peaux
(valvules), annexées à l'orifice des quatre gros vaisseaux,
fo rmant autant de "petites por tes" qui s 'ouvrent ou se
fe rment au passage du sang. Elles sont au nombre de
" t ro is" aux entrées de la "veine cave", de la "veine
ar tér ieuse" et de la "grande a r tè re " ; mais deux
seulement à celle de I "ar tère veineuse", qui est ovale.
Ces " petites peaux " s'opposent au reflux du sang
après sa lancée, sans que soit en aucune manière
entravée sa direct ion normale.
Il est à noter, dit Descartes, que la "grande ar tère" et
la "veine artér ieuse" sont d'une composi t ion "beaucoup
plus dure et plus ferme que ne sont l 'artère veineuse et
la veine cave" ; aussi, ces deux dernières s'élargissent-
elles à l 'entrée au coeur et y font-elles "comme deux
bourses, nommées les oreil les du coeur, qui sont
composées chacune d'une chair semblable à la sienne ".
Telles sont les orei l lettes du coeur; chaque orei l le t te
communique avec le ventr icule correspondant par un
ori f ice auriculo-ventr iculaire.
On est en d ro i t de se demander comment le sang des
veines ne s'épuise pas en coulant ainsi cont inuel lement
dans le coeur et comment les artères ne sont pas t r op
remplies, puisque t o u t le sang qui passe par le coeur va
s'y rendre. La réponse a été appor tée par "un médecin
d 'Angleterre, auquel il faut donner la louange d'avoir
rompu la glace en cet endroi t , et d'être le premier qui a
enseigné qu' i l y a plusieurs pet i ts passages aux
ext rémi tés des artères, par où le sang qu'elles reçoivent
du coeur ent rent dans les petites branches des veines,
d'où il va se rendre derechef vers le coeur, en sor te que
son cours n'est aut re chose qu'une c i rcu la t ion
perpétuel le".
C'est, en effet, au médecin anglais Wi l l i am Harvey
(1578-1657) que revient le mér i te de la découverte de
la circulation du sang; il exposa les arguments probants
en faveur de cet te théor ie , dans son célèbre ouvrage
"Exercitat io anatomica de mo tu cordis et sanguinis in
animalibus", édité à Francfort en 1628.
Selon Descartes, il y a plus de chaleur dans le coeur
qu'en aucun autre endro i t du corps, et c'est cet te
chaleur qui fait que la plus peti te quantité de sang, qui
en t re dans une de ses "concavi tés", s'enfle
imméd ia temen t et se di late, comme le fon t
généralement toutes les liqueurs lorsqu'elles tombent
dans un vaisseau qui est f o r t chaud. La moindre " goutte
de sang " appo r tée à la cavité d ro i t e du coeur par la
"veine cave" et à la cavité gauche par I' "ar tère veineuse"
se dilate en raison de la chaleur qu'elle y t rouve, et cette
di latation "faisant enfler" t o u t le coeur fait que le sang
appor té pousse et ferme les "cinq petites portes qui
sont aux entrées des deux vaisseaux".
Au t remen t dit, d'après la théor ie de Descartes, ce
serait la diastole qui serait le temps moteur de la
circulat ion du sang. Mais Descartes n'explique pas d'où
provient cette prétendue chaleur du coeur.
La théor ie cartésienne de la circulation du sang fut
reprise des années plus tard , bien après la m o r t de
Descartes, par d'autres théoriciens, et notamment par
Pierre Chirac ( 1650-1732) qui fut le Premier médecin de
Louis XV et, de plus, le quasi-créateur de l'Académie
nationale de médecine.
Selon Pierre Chirac, le sang véhiculerait une substance
acide et ce t te substance, au contac t du coeur,
déclencherait une réact ion chimique, laquelle dégagerait
de la chaleur et cet te chaleur, en dilatant la masse
sanguine, ferait avancer le sang dans les artères.
Ce t t e t héo r i e fondée sur l'acidité du sang est
complè tement caduque aujourd'hui, maintenant que l'on
sait que le sang a un pH légèrement alcalin.
Elle fu t cependant revendiquée par Raymond
Vieussens ( 1641 -1715), qui fut professeur de médecine a
l 'Université de Montpel l ier ; il y eut, entre Chirac et
Vieussens, une querelle épistolaire qui fut longue et
acr imon ieuse, chacun des deux protagonistes
revendiquant, avec force, la paternité de cette idée
fausse:
"Je n'eus pas p lu tô t fait part de mon travail sur cette
l iqueur (l'acide du sang) aux savants, qu'il plut à un jeune
professeur de cet te ville (Pierre Chirac), de prendre de
là l'occasion de marquer sa mauvaise humeur cont re
moi ; i l a écr i t et fait impr imer t ro is letters contre moi ,
les plus outrageantes qu'on puisse écrire contre un
homme qui est auteur, comme on sait que je le suis...",
écrivait Vieussens.
"Pourquoi avez-vous fait rouler clandestinement dans
tou te l'Europe une let t re manuscrite, dans laquelle vous
vous donn iez l ' honneur de ma découve r t e ?... A i - je
pu moins faire que de réclamer un bien injustement
usurpé ? ... Si j'ai parlé naturel lement de vot re invasion,
si je vous ai t ra i té de plagiaire et de plagiaire d'habitude,
ne m'en avez-vous pas donné le sujet ?", répondait
Chirac.<3>
Pourtant, Wi l l iam Harvey avait admirablement décri t
32
C a r t é s i a n i s m e e t c i rcu la t ion sanguine,Vesal ius, I X , 2 , 3 1 - 3 4 , 2 0 0 3
le rôle et le fonct ionnement du coeur, en s'appuyant sur
de longues et patientes recherches, et même sur des
démonstrat ions mathématiques, qui durèrent vingt ans
et lui permirent f inalement de rédiger son "De mo tu
Cordis" , qui devait révolut ionner la science médicale.
Pour Wi l l iam Harvey, le coeur, muni de son système
valvulaire est, à juste t i t re , une pompe musculaire à effet
hydraulique. La systole est cette contract ion du muscle
cardiaque qui chasse le sang dans les artères et la
diastole, ce relâchement du muscle cardiaque qui
permet le re tour du sang au coeur.
Il faut cependant reconnaître, à l'avantage de René
Descartes, que celui-ci avait bien observé la différence
d'aspect et de consistance entre le sang artér ie l et le
sang veineux. René Descartes écrivait :
".. la différence qu'on remarque entre celui (le sang)
qui sor t des veines et celui qui sor t des artères ne peut
procéder que de ce qu'étant raréfié et comme distillé en
passant par le coeur, il est plus subtil et vif, et plus chaud
incontinent après qu'il en est sor t i , c'est-à-dire étant
dans les artères, qu'il n'est un peu plus devant que d'y
entrer, c'est à-dire étant dans les veines ; et si on y prend
garde, on t rouve que cette différence ne paraît bien que
vers le coeur et non point tant aux lieux qui en sont plus
éloignés ".
Wi l l iam Harvey ne décr i t pas la différence de couleur
du sang (rouge vif pour le sang ar tér ie l , rouge foncé pour
le sang veineux); sans dou te est imai t - i l que ce
changement d'aspect "après le passage dans le coeur"
sortai t du cadre de son exposé : "ce mouvement du
coeur est, en somme, une contract ion musculaire", écr i t -
il ; et la contract ion intéresse d'abord les orei l let tes,
assurant ainsi le passage du sang des cavités auriculaires
aux cavités ventriculaires, puis elle se t ransmet aux
ventricules.
Discussion
Dès le X l l le siècle, le médecin et phi losophe arabe, Ibn
an-Nafis (1210-1288), avait décr i t la pet i te circulat ion
(1260). Pour lui, le sang ne passait pas de la cavité dro i te
du coeur à la cavité gauche à travers le septum
ventriculaire, mais bien par le poumon pour s'y mélanger
avec l'air. Malheureusement, la découverte d'Ibn an-Nafis
n'eut aucun écho et ne fut connue qu'au début du X X e
siècle.<4)
Harvey a été, certes, le premier à bien comprendre et
à décrire la circulation du sang ; mais il faut reconnaître
que le "médecin anglais" a fait ses recherches en
s'appuyant sur de solides bases préexistantes.
C'est au médecin espagnol Michel Servet (1509-1553)
que revient le mér i te d'avoir aboli, d'une manière
définitive, l'antique théor ie galénique, selon laquelle la
circulation sanguine se l imite au passage du sang de la
cavité dro i te du coeur à la cavité gauche, à travers les
pores imaginaires du septum ventr iculaire.
Michel Servet a, en effet, mon t ré l'existence d'une
circulat ion pulmonaire, dans son ouvrage " Christ ianismi
Rest i tut io "(5) Il a conclu que le sang pénétrant dans les
poumons par la "veine ar té r ieuse" , en quant i té
supérieure à ce que nécessite la nut r i t ion du poumon ,
revient au coeur par les "artères veineuses", après s'être
mélangé avec le "pneuma", à l ' intérieur même des
poumons.
Il fu t le découvreur de la pet i te circulat ion mais sa
découverte passa inaperçue, car elle se perdait dans un
ouvrage de théologie, don t les volumes furent brûlés sur
le bûcher, en même temps que l'auteur comme hérétique.
En 1558,1' italien Realdo C o l o m b o ( 15 16-1559), dans
son "De Re anatomica,"(6) conf i rmai t les idées de Michel
Servet sur la pet i te circulat ion.
Elève de Realdo Co lombo , And ré Césalpin (1519-
1603) affirmait que dire que le foie était l'organe de
sanguinification et le po in t de départ des grosses artères
- tel que le concevait le système galénique - était une
er reur fondamentale.<7>
Aussi claire et précise que fût la vision de Wi l l i am
Harvey du mouvement circulatoire, sa découverte fut
complétée par le médecin italien Marcello Malpighi
(1628-1694) qui, en 1661, découvrai t les capillaires
sanguins et les substituait aux anastomoses ar té r io -
veineuses de Harvey.(8) La découverte harveyenne fut
parachevée par les recherches de Gaspard Aselli (1581-
1626), de C rémone , qui about i rent à la reconnaissance
de la c i rcu la t ion du chyle dans les vaisseaux
lymphatiques, corol laire de la circulat ion sanguine.<9)
L'invention de Wi l l i am Harvey déclencha une véritable
guerre "de plume" ; il se fo rma deux clans : les
circulateurs et les anti-circulateurs.
Parmi ces derniers, le plus docte et le plus violent fut,
sans conteste, Jean Riolan (1577-1657), di t " le prince
des anatomists ", médecin de la reine mère et de Louis
XI I I , qui à la seule idée que Galien pût avoir affirmé des
erreurs. Quan t au verbeux Gui Patin (1600-1672), fu tur
doyen de la Faculté de médecine de Paris (1650), il ne
manqua pas d'exercer sa verve caustique cont re la
circulat ion sanguine.
Au nombre des partisans de la doct r ine harveyenne,
on do i t c i ter le Danois Niels Stensen (1636-1686), dit
Nicolas Stenon (le découvreur du canal excré teur de la
parot ide), l'Anglais Richard Lower (1631-1691), auteur
du "Tractatus de corde" , et Raymond Vieussens, bien que
celui-ci restât fidèle à la doct r ine cartésienne.
La concept ion de Wi l l i am Harvey allait être adoptée à
l 'unanimité par le corps des savants, lorsque survint
l'obstacle qui brisa l'élan.
33
C a r t é s i a n i s m e e t c i rcu la t ion sanguine,Vesal ius, I X , 2 , 31 -34 , 2003
Ce ne fut pas René Descartes qui " m i t des bâtons
dans les roues ", mais bien sa doc t r i ne , le
"cartésianisme".
Il fallut at tendre cinquante ans pour que fût adoptée
off iciel lement la vérité. ( l0 )
En 1672, en effet, Louis XIV, excédé par la querelle de
la c i rcu la t ion , décida la r é o u v e r t u r e des cours
d'anatomie au Jardin du Roy, pour y enseigner la nouvelle
doct r ine, celle de Harvey. Ce fut Pierre Dionis qui fut
chargé de cette mission ; il l 'entrepri t à par t i r de 1673.
Mais le cartésianisme faisait tou jours des adeptes ; la
concept ion cartésienne du mécanisme cardiaque et
c irculatoire a paru longtemps claire et satisfaisante, sans
doute parce qu'elle concil iait une concept ion acceptable
par la religion et le sens commun.
Le dernier m o t revenait au naturaliste et religieux
Lazzaro Spallanzani (1729-1799) qui démon t ra i t à
nouveau, en 1771, que la poussée donnée par le coeur
entretenai t la circulat ion de t o u t le t ronc ar tér ie l ,
jusqu'aux dern iers capil laires, sans qu' i l y ait
d ' in ter rupt ion. Ceci revient à dire que le coeur se vide
ent ièrement pendant la systole." I ) ( l2>
Conclus ion
Pourquoi a-t-il fallu tant d'années pour que la réalité
des choses soit, une fois pour toutes, sol idement établie?
Avant d'atteindre son niveau actuel, la connaissance de
la physiologie cardiaque et c i rculato i re, née de la
découverte de Harvey, devait encore s'enrichir de
données nouvelles qui ne s'achevèrent que dans la
seconde moi t ié du X I X e siècle.
10.
12.
Malpighi, Marcel lo : " De pulmonibus observationes
t radui te en français : " Discours anatomiques sur la
s t ructure des viscères ", t radui t par Sauvalle M.,
d 'Houry, Paris, 1683.
Asell i , Gaspard : " De lactibus sive lacteis venis ".
Milan, 1627.
Vetter, Théodore : " Un siècle d'histoire de la
circulation du sang 1564-1664 ". - Six fascicules -
Laboratoires J. R. Geigy, Bâle, Suisse, 1965.
Castigl ioni, A r t u r o : " Histo i re de la Médecine "
Edition française. Payot, Paris, 193 I - p. 502.
Rullière, Roger : " Histo i re de la cardiologie et des
affections vasculaires " Sandoz édit ions, Paris, 1975.
Biograph ie
Doc teu r en médecine (Paris), docteur en histoire-
philosophie des sciences (Paris-Sorbonne), t rois fois
lauréat et médaille d'argent de l'Académie nationale de
médecine, Jean-Jacques Peumery est l 'auteur de
plusieurs ouvrages et de nombreuses publications sur la
pneumologie et sur l 'histoire de la médecine.
2.
Bibl iographie
I. Descartes, René : " Discours de la méthode; les
passions de l'âme " - Hi lsum, Paris, 1932. " Discours
de la méthode " - Editions Mille et Une Nui ts.
A r t h e m e Fayard, Paris, 2000 - pp. 5-75.
Descartes, René : " De Homine , figuris et latinitate
donatus a Florent ino Schuyl " Leffen et Moyard,
Leyde - 1662-Nouvelle édi t ion, Hack, Leyde, 1664
" Let t re de M. Chirac ou réflexions préliminaires
sur l'apologie de Vieussens, et sur la préface qui la
précède " .A Montpel l ier, décembre 1698, 17 pages.
Meyerhof, Max :" Ibn an-Nafis und se ineTheor ie des
Lungenkreislaufs " - Quel l . Stud. Gesch. Naturwiss.
Med . ,4 ,37 (1933)
Servet, Michel : " Christ ianismi Rest i tut io " -V ienne,
1553 - Réimpression: Murr, Ch . G. von, Nuremberg ,
1790.
Co lombo , Realdo : " De re anatomica l ibri XV ".
Bevilacqua, Venise, 1559.
Césalpin, And ré : " Quaest ionum per ipatet icarum
libri quinque ". - Junte,Venise, 1571.
6.
7.
34
Reports of Congresses and News,Vesalius, IX , 2, 35-40, 2003
Reports of Congresses
The USSR (1959-1986)
In May 2003, the second Congress of Confederation of Historians of Medicine took place in Moscow. It is too early to speak about its merits and demerits now; but some historical explanation is necessary. However, it is already completely clear that this Congress was a final event in the activity of the All-Union Scientific Historical and Medical Society which united us for almost half a century.The All-Union Society of Historians of Medicine itself became history and it is time to engage in its historiography.
The first step in this direction should be the account of the All-Union Conferences and Congresses of the Historico-Medical Society.There were major landmarks on the way of building a Historico-Medical community in the USSR. As each next Conference was awaited, the members prepared for it and it then became a milestone in the biography of its participants.
The first cells of the Society of the Soviet Historians of Medicine arose on the wave of national patriotic enthusiasm which involved all layers of our society after the Second World War.The demand to study the history of our multinational Motherland, its culture and science, arose, as well as the history of Medicine and Public Health services, was the basis for creation of historical societies at the time. The first societies of historians of Medicine began in Moscow (M. I. Barsukov, D. I. Rossiysky, I. D. Strashun), then in St Petersburg (A. S. Georgievsky), and then in Ukraine (S.A.Verhratsky, K. F. Duplenko), in Belarus (G. R. Kryuchok), in Latvia (P. I. Stradyn), and other Republics and cities of the Soviet Union. However these were all isolated organizations and to co-ordinate their work in 1958 the first All-Union Historico-Medical Conference was held. All the organization of the Conference was undertaken by a small group of Moscow and Petersburg (Leningrad) scientists, headed by one of the most outstanding organizers of the Soviet public health services, Michael Ivanovich Barsukov (1890-1974). Leningrad (St Petersburg) was chosen as the location for the first All-Union Conference.
The role of Leningrad's (St Petersburg) Medical-historical organization, now based in the Military medical museum, is particularly important.. Without the help of the management and employees of the museum, the Conference would not have taken place. The Chairman of the Leningrad branch of the society was a military General of the Medical Service, Professor Anatoly Sergeevich Georgievsky (1908-1998). The Military medical museum provided all the technical support for the convocations, and organized and supported the first three All-Union Medical History Conferences.
Sessions of the 1st All-Union Conference of History
of Medicine were held in the Military medical museum from 3rd - 9th February 1959. There were more than 200 delegates from the majority of the Republics of the Soviet Union, and visitors from Bulgaria, Hungary, GDR, Poland and Czechoslovakia also attended.
At the Conference 80 papers, on questions of history in general, private medicine, methodology and the technique of its study, with the development of Soviet medicine within the Union Republics, and of history of Military Medicine, were given. At the Conference the charter of the All-Union Medical Historical Society was approved and its office-bearers were elected - M. I. Barsukov as chairman of the society, and A. S. Georgievsky as his assistant. The general secretary was A. R Zhuk, later followed by A. G. Lushnikov.
The Conference also showed that all of us who are engaged in History of Medicine could be easily subdivided into two unequally sized groups. The first were members of faculties and departments, few in number, devoted entirely to the study of medical history, as well as those teachers conducting a formal course in History of Medicine. These made history of medicine their basic specialty and they can be considered professionals in this area.
Secondly, there is the rather large group of amateurs engaged in the study of medical history. These are doctors, scientific employees, and teachers, engaged in the history of Medicine, while simultaneously working in other areas of medical science. For them, study of medical history is one of the ways of enhancing and perfecting the depth and knowledge of the scientific development of their own chosen specialty. They are therefore usually engaged only in the history of the disciplines and problems of their own clinical or scientific specialty, and work actively in its Republican, regional and territorial branches.
In October, 1963, the 2nd All-Union Scientific Conference of historians of Medicine was held in Petersburg, again in the Military medical museum. It coincided very closely in time with the unprecedented earlier public enthusiasm of the sixties, and this was reflected both in the contents of the papers and in the Conference programme. At this Conference, discussions about the mutual relationship of history of medicine with social studies and the philosophical education of a doctor, were first made. Russian native doctors, who had played a prominent part especially in the social development of Russia (N. I. Pirogov, S. P. Botkin, I. M. Setchenov) were honoured.
In its formal resolutions, the Conference recommended improvement in the teaching of History of Medicine, and also stressed the necessity of creating
35
Reports of Congresses and News,Vesalius, IX , 2, 35-40, 2003
museums of medicine as bases for educational and scientific work. Conference also demanded that special attention be paid to the history of the Soviet public health services ('History of Medicine of the Soviet period') and it also resolved:'to show the successes and achievements of the Soviet Public Health Services and Medical Science.'
The 3dAII-Union Conference held in December, 1967 in Petersburg was, in essence, devoted to this aim. It was held in commemoration of the 50th anniversary of the October Revolution. Among 41 papers included in its programme, 30 covered the history of the Soviet public health services and medicine.
The 4th All-Union Conference was held in June 1970 in Minsk and was dedicated to the hundredth anniversary of Lenin's birth. It appreciably differed from the previous ones. It was tightly thematic and solemn. The names of the basic sections of its programme testify to the contents of the Conference reports. The first section: 'V. I. Lenin and problems of public health services;' the second section: 'V. I. Lenin and national policy in public health services;' the third section: 'V.I. Lenin and problems of historicism in medicine' and the fourth section: 'Medical intelligences in the socialist society and problem of deontology in the light of Marxist - Leninist theory.' How enthusiastically one of the speakers said at the Conference: 'We are agitprop (agitation propagandists) of Soviet health protection.' And it has to be said that the Conference coped successfully with its aim, although its scientific content suffered. Confining medical history conferences to only one problem is impossible. It at once excludes the large number of members whose scientific interests are extremely various.And so it was necessary to find a new form of scientific dialogue, where discussion of two or three main issues would be combined with discussion of other questions (perhaps at first sight of only minor interest). The Congresses where plenary sessions were alternated with sectional ones, devoted to separate, more particular directions of researches, produced such a forum.
The next Congress (called 1st once more) was held in October, 1973 in Moldova, in Kishinev. Its themes, except for discussion on 'Problems in the light of the resolutions of the 24th Congress of the CPSU,' were historiography and study of sources of home history and of medicine, and questions concerning teaching. There were plenary and sectional sessions (12 sections). At the end of the Congress re-elections of the board and the chairman were carried out - the chairman of the board, M. I. Barsukov (he was 83 years at that time) was replaced by Jury Pavlovich Lisitsin. He was one of the
management leaders of Soviet social hygiene, and by using his appreciable influence in the allied Ministry of Health, he raised the authority of the All-Union Society of Historians of Medicine immediately.
The experience of the first Congress was used during the organization of the 2nd Ail-Union Congress of Historians of Medicine, held in September 1980 in Tashkent.This was the biggest assembly of historians of medicine in the entire history of the All-Union Society. Delegations from all allied Republics and from some foreign countries were present.. The plenary meetings were alternated with sectional ones. 14 sections worked simultaneously.
The themes of the convention were: 'A prominent scientific encyclopaedist Ibn-Sina (Avicenna) and influence of his works on development of world medicine' and 'Methodology of study of History of Medicine.' The Congress in Tashkent was the last major event in the life of the All-Union Scientific organization of Historians of Medicine.
The 3rd Congress was considerably lesser in scale compared to the two previous ones. It was held in November 1986, in a small resort, Kobuleti in Adgaria. Programme themes at the Congress were: 'Development of theoretical bases of medicine and public health services' and 'History of prophylactic direction of Medicine.'
This was the last Congress of the All-Union Scientific organization of Historians of Medicine. In 1992, at the session of the next plenum of the board, it was transformed into the Confederation of the Societies of medical historians working in the territory of all Republics of the former Soviet Union, which now became the sovereign states.
Reorganization of the All-Union Society of Historians of Medicine into the Confederation was indisputably a correct step. It allowed the retention with the least losses to the community of historians of medicine, which had existed for 50 years in the territory of the USSR, the coordination of the activity of numerous republican, regional and city historico-medical organizations, and allowed joint historico-medical Conferences and symposia to continue, while also retaining communications with international medical history organizations.
Conferences and Congresses are an important parameter of the state of a historico-medical society and studying their history in the former Soviet Union testifies to direct correlation between general social and economic situation in the country and practical activities of this society.The peak in the activities of the society of
36
R e p o r t s o f Congresses a n d News,Vesa l ius , I X , 2 , 3 5 - 4 0 , 2 0 0 3
historians of medicine in the USSR fell in the eighties
when the first crises in the life of the Soviet society
came to light. Then a sharp recession in the activity of
the Society of Historians of Medicine, which reached its
maximum in the middle of the nineties, fo l lowed.
The Congress of Confederat ion of Historians of
Medicine of the Republics of the f o rmer USSR held in
May, 2003 in Moscow testifies to the upsurge in the
activity of the societies of historians of medicine in the
post-Soviet per iod.
Vasylyev G. Kostyantyn (Odessa, Ukraine)
Reading 2003 The 20th Br i t ish Congress f o r the H i s t o r y o f
Medicine was held at the University of Reading, f r om
Thursday 4th to Sunday 7th September. The Congress
organisers were Mr D e r m o t t O 'RourkeJ i l l Seagers, Dr
Denis Gibbs, President, Dr Helen King, Reader in
Classics at the University of Reading, and Dr Marshall
Barr, H o n o r a r y Consu l t ing L ibrar ian, Reading
Pathological Society.
Registration started on Thursday, and participants
then were able to view exhibit ions in the Cole Library,
the Typography department, the Cent re fo r Ephemera
Studies, the Museum of Rural Life, a Veter inary
exhibi t ion, and poster displays. A dinner was held in
Whi teknights Hall.
The f irst day of the Congress was opened by Dr
Denis Gibbs, fo l l owed by a we l come f r o m Vice
Chancellor of the University, Professor Go rdon Marshall
CBE, DPhil, FBA. The opening address was given by
Professor Vivian N u t t o n on Greek Medicine in Rome, Sir
CliffordAllbutt and ofter.This was fo l lowed by eight papers
on ancient and medieval medicine, and varia. A f te r tea a
coach t o o k everyone to the Royal Berkshire Hospital
for visits to the Pathological Society Library, the O l d
Laundry Medical Museum, the Wal l Tiles, and the Chapel.
This was fo l lowed by a very interesting private visit to
Mapledurham House, during which Concorde f lew over,
and then a dinner at Caversham Heath Gol f Club, where
the eightieth birthday of the incoming president, Dr
Ai leen Adams CBE, was celebrated w i th a big birthday
cake.
On Saturday 6th September, seventeen shor t papers
were presented. In the morn ing the subjects were
Medicine in the Thames Valley, and in the af ternoon on
veter inary medicine, and varia.
At the evening recept ion a t Wh i tekn igh ts Hal l ,
Anne t te H o w a r t h , D i rec to r o f Informat ion Services for
the University, we lcomed the participants. The Congress
Dinner fo l lowed, w i th the BSHM being toasted by Dr
Hugh Simpson, and the response by Dr Denis Gibbs.
There were four papers on Sunday morning, fo l lowed
by a business session. Dr Ai leen Adams was inaugurated
as the incoming president, Dr Ann Ferguson, elected as
secretary, and Dr John W a r d as President elect. The
congress finished w i th grateful thanks to the organisers.
The next Congress wi l l be in Exeter, f rom I st to 4 th
September 2005.
Ann Ferguson FRCA DHMSA Secretary BSHM
37
THE LITERATURE (this is a series of references in Russian script)
R e p o r t s o f Congresses and News.Vesa l ius , I X , 2 , 3 5 - 4 0 , 2 0 0 3
Rapport de congrès 11° réunion de la Société Internationale
d'Histoire de la Médecine Mexico, 17-20 septembre 2003
Du 17 au 20 septembre 2003, a eu l ieu, à Mexico, la
deux ième réun ion de la Société In ternat iona le
d 'Histoire de la Médecine. Cet te réunion a pu être
organisée grâce au soutien de la Société Mexicaine
d 'H is to i re et de Phi losophie de la médec ine, du
Dépar tement d 'Histoire et Philosophie de la Médecine
de la Faculté de Médecine de l 'Université A u t o n o m e de
Mexico et de la SIHM.
Le thème pr incipal de ce t te réun ion éta i t
l 'enseignement de l 'histoire de la médecine ; cinq
sessions on t été consacrées uniquement à ce sujet
durant les matinées des 17, 18 et 19 septembre. Ici a
été soulevée la problémat ique actuelle d'inclure ce cours
dans le curr icu lum universitaire, t o u t en ne négligeant
pas les aspirations estudiantines particulières. Les autres
thèmes por ta ient sur les échanges scientifiques entre le
vieux et le nouveau monde, les musées d'histoire de la
médecine et des sciences, l 'histoire de la psychiatrie,
l 'éthique médicale et l 'anthropologie médicale ; plusieurs
sessions " varia " étaient également prévues.
Une session a été consacrée à la présentat ion de
livres tels que " Comprender y curar Philippe Pinel y la
medicina de la mente " de D o r a W e i n e r et " Henry Ey
y el pensamiento psiquiâtr ico contemporâneo " de Jean
Garrabé. La cérémonie de c lôture quant à elle a permis
la présentat ion des travaux de recherches de François
Delapor te , Gary Ferngren et Do raWe ine r .
Les langues officielles de la Réunion étaient l'espagnol,
l'anglais et le français. La cérémon ie d 'ouver tu re ,
présidée par Car los Viesca chef du Dépa r t emen t
d 'Histoire et de Philosophie de la Médecine, Jean Pierre
Tr icot Président de la Société Internationale d 'Histoire
de la Médecine, Gary Ferngren secrétaire général adjoint
de la même Société et Rolando Ner iVela président de la
Société Mexicaine d 'Histo i re et de Philosophie de la
Médecine. Les professeurs Vescia et Tr icot se sont
expr imés tous deux dans les t ro is langues officielles et
Jean-Pierre Tr icot a insisté sur l ' importance de l'espagnol
au sein de la Société Internationale d 'Histo i re de la
Médecine. A no te r que certains sujets t rès originaux
furent abordés sous l' impulsion du Professeur Vescia qui
f i t lu i-même une in tervent ion sur " L'inclusion de
modèles non occ identaux dans l 'enseignement de
l 'h istoi re de la médec ine : ses conséquences
épistémologiques ". L'orateur insista sur le fait que
lo rsqu 'on étud ie les systèmes médicaux non
occidentaux, beaucoup t r o p peu d ' importance est
accordée aux t radi t ions séculaires médicales indigènes.
Celles-ci valent cependant t o u t autant la peine d'être
analysées que la t rad i t ion hippocrat ique et galénique.
Etant lui-même auteur de plusieurs ouvrages de
référence sur la médecine précolombienne, le Pr.Viesca
conclut que lorsqu'on t ient compte de plusieurs autres
modèles que ceux sur lesquels on se base actuel lement,
on élargit l 'horizon à une « méta-histoire » de la
médecine. On réalise aussi que nos connaissances
médicales d 'au jourd 'hu i ne sont ni déf ini t ives, ni
absolues. Ce point de vue mexicain - en fait latino-
amér icain - s'applique aussi aux médecines
tradit ionnel les des autres continents tels que l 'Afrique,
l'Asie et les pays arabes. Cet te réf lexion rejoint l'esprit
du nouveau projet de la SIHM : «Thésaurus Metableticus
Histor iae Medicinae » : la récol te et la diffusion la plus
large d ' in fo rmat ion médico-h is to r iques au-delà de
toutes les disciplines, toutes les époques et toutes les
populat ions.
Bien que la Réunion fut t rès chargée en activités
académiques, le programme social a été ex t rêmement
enrichissant avec, entre autres, l ' inauguration d'une
exposi t ion de livres anciens appartenant au Fond de la
Bibl iothèque Nicolas Leôn du Dépar tement d'Histoire
et de Philosophie de la Médecine et la visite du musée
d'histoire de la médecine de Mexico. La journée du 20
sep tembre fû t consacrée à la visi te de la vil le
archéologique de Teotihuacan ; le groupe a été guidé et
imprégné de l'histoire de cette ville grâce à la sœur de
Carlos Vescia qui fut un guide exceptionnel par son
enthousiasme et son savoir.
L'excellente organisation de cette réunion, due au
Prof.Vescia et à sa famille, permi t aux participants de se
re t rouver ou de faire connaissance dans une ambiance
chaleureuse typ iquement mexicaine.
Malgré certains difficultés d 'obtent ion du visa qui
empêchèrent certains membres de rejoindre le centre
de congrès, la deuxième réunion de la S.I.H.M. réunit un
tota l de I 15 participants et leurs accompagnants ; 100
résumés on t été acceptés et 72 travaux originaux on t
été présentés. De nombreux pays étaient représentés
et les conférenciers étaient issus des pays suivants :
Argent ine (2), Belgique (2), Brésil ( I ) , Chil i ( l ) , C u b a (2),
Etats-Unis d 'Amér ique (2), France (3), Italie ( I ) , Mexique
(48), Pérou ( I ) , Philippines ( I ) , Roumanie ( I ) , Royaume
Uni ( I ) ,Turqu ie (4), Uruguay ( I ) et Venezuela ( I ) .
Le bilan de ce congrès est donc des plus positifs. Il
permet à la Société Internationale de se confor te r dans
l'idée que l'organisation de ces réunions intermédiaires
aux congrès bisannuels, lancée par le Président Jean-
Pierre Tr icot , joue un rôle considérable dans les relations
professionnelles et humaines de cette Société.
Nous ne pouvons conclure ici qu'en remerciant le
Prof. Carlos Vescia, délégué national du Mexique et sa
famille qui, malgré le ter r ib le deuil qui les a touchés, on t
pu mener à bien cet te deuxième réunion internationale
si réussie.
AndrésAranda (Mexico)
Diana Gasparon (Belgique)
38
Reports of Congresses and News,Vesalius, IX , 2,35-40, 2003
Italy
The I st Italian National Convention on the History of Military Medicine took place in Florence on 8-9th November, 2003.
This Congress, the first of its kind, was oganised by the Italian Army Medical Services and the International Red Cross. It was held in the imposing College of Army Health, Chiostro del Maglio, 5, Via Venezia, whose centenary was in 1982.
The Honorary presidents were Ten. General Michele Donvito and Prof.Augusto Marinelli.and the Convention presidents were Brig. General Frederico Marmo and Prof. Paulo Vanni. Brig.General Antonio Santorno, Prof. Giuseppe Armocida and Dr Francesco Caponi ran the organising committee, and the scientific committee included the distinguished historian Prof. Donatella Lippi.
Subjects ranged from ancient times to the present, and included policies and planning, treatment of surgical and medical disease, epidemiology and army health, and the contributions of notable figures in both the Armed
Forces and the International Red Cross.The opening talk was by Dr Gregory R. Ciottone, who described the planning and immediate action of his Division of Emergency Medicine at Harvard Medical School following the events of 9th September in New York.
Dr J.Cule, past president, ISHM, and J.Blair (Colonel, retd, British Army Medical Services TA) were invited guests of Professor Vanni. Prof. A. Musajo-Somma and Mrs D. Gasparon of ISHM also read papers.
The congress was primarily a military one.The major evening event and dinner had as background a parade of the Italian Army, with their band, and included a wreath-laying ceremony.
Our Italian hosts could not have been kinder or more welcoming, and all those taking part enjoyed the event greatly.
JSG Blair, vice-president, ISHM
News from Finland
The Department and Museum of Medical History at the University of Helsinki has been closed down since November 2002. All the items and the library were packed up in order to be moved to the new Museum building in downtown Helsinki. The Museum of Medical History will become a part of the Helsinki University Museum together with the other small museums at the University. In the new Museum there will be, besides the University museum of course, separate departments for geology, medical history, odontological history, veterinary medicine, pharmacy and handicraft and the world of students.
The course on the history of medicine arranged during the winter by the Department and Museum of Medical History at the University of Helsinki was attended by about 60 active participants.
The annual meeting of the Finnish Medico-Historical Society was held on the 24th of February, with a lecture by professor Bror-Axel Lamberg on the history of goitre in Finland in the 19th century.
At the end of February 2003 the 19th volume of the yearbook'Hippokrates' of the Finnish Medico-Historical Society was published, with articles such as: 'An old
teaching collection in the Pharmacy Museum in Turku and features of botany in early 19th century Finland;' 'Semmelweis and Finland;' 'Yrjo V Paatero - the discoverer of panoramic radiography' and 'Mondino de Liuzzi and his Anatomia Mundini".'
At the end of March the I Ith Gunnar Soininen lecture, named after the founder of the Society, was given to a large audience by professor Matti Haltia who had entitled his lecture 'The Early Stages in Neuroscience in Finland from the 17th to the 20th Centuries.'
The main activities of the Medico-Historical Society of Eastern Finland in spring 2003.
The annual meeting of the Medico-Historical Society of Eastern Finland was held on the 26th of February at the Department of Pharmacy of Kuopio University.The apothecary, Docent Jukka Gynther presented a paper 'The University Pharmacy in Kuopio, yesterday, today and tomorrow.' The vice-rector of the University, Professor Katri Vehvilainen-Julkunen presented the second paper 'The University of Kuopio today and tomorrow' The University of Kuopio has become wide-
39
R e p o r t s o f Congresses a n d News.Vesa l ius , I X , 2 , 3 5 - 4 0 , 2 0 0 3
ranging in its subject areas relating to Health Care.
The Mannerheim League fo r Children's Wel fare
founded fifty years ago a very famous hospital fo r
chi ldren in the Ci ty of Kuopio, named Savon Lastenlinna,
(Children's Castle), w i th very fine architectural features.
The hospital has now closed and the Medico-Histor ical
Society took , at its annual meeting, the f irst step towards
preserving the archi tecture of the hospital buildings.
The Society t o o k part in the meeting of the Society
o f the Senior Apo thecar ies when the chairman
Professor Juhani Karja spoke on the old garden fo r
medicinal herbs founded in 1777 in connect ion w i th the
f i rst pharmacy in Eastern Finland.
T h e S o c i e t y f o r t h e H i s t o r y o f M e d i c i n e i n T u r k u
The Society fo r the His tory of Medicine in Turku held
its annual meeting on the I I th of March at which there
was given a lecture on the death of Wolfgang Amadeus
Mozart . An excursion was planned in the beginning of
September to the Psychiatric Hospital Mayryniemi in
Halikko. In October , the theme of the meeting was
'Memor ies of the early years (1940-1958) of the Medical
Faculty and the Central Hospital of Turku.'
Hindrik Strandberg and Juhani Karja
News from Chile
The f irst Chilean society of H is to ry of Medicine was
founded in 1955 by Professor Enrique Laval, MD and the
Dean Ale jandro Gar re ton , MD.The society encompasses
some 30 members and edited a journal Anales Chilenos
de His tor ia de la Medicina,' wh ich was published
between 1959 and 1973 and discontinued after the
death of both founders. A lso a museum and historic
l ibrary we re founded in a building of the Nat ional Health
Service in Macul Avenue in Santiago. In 1988 the Museum
was closed, and was transferred to the University of
Chi le School of Medicine and merged w i t h histor ic
artifacts of the Faculty of Medicine and the ancient
Hospital San Vicente. Consequent ly the University of
Chile founded a united 'Museo Nacional de Medicina' in
the new building of Independence Avenue. A full
descr ipt ion of the new Museum by R.Cruz-Cole MD,
was published in Revista Medica de Chile,Vol I 17; 1073-
1078, 1989.
Today, the Chilean medical historians are grouped in
the historic commission of the Academia Chilena de
Medicina, founded in 1964 w i t h some 40 active
members. Papers are published current ly in the Revista
Medica de Chi le. Every three years a national conference
is held, the'Jornadas de Histor ia de la Medicina. 'The fifth
Jornadas was held in O c t o b e r 2002 and attended by 30
participants, w i th 18 papers dealing w i th classical and
national subjects on H is to ry of Medicine.The Editors of
these Proceedings were Professors Alecsandar Goic MD
and Ricardo Cruz-Coke MD.
Only a few medical academicians have been members
of the I.S.H.M. The late Professor Claudio Costa
Casaret to M.D (1914-1998) studied in Rome in 1954
w i th Professor A lbe r t o Pazzini and attended a Congress
of ISHM.The late Ramon Campbell Batista (191 1-1999)
at tended the Congress in Kos in 1996.
The remaining members are academicians Professors
Cami lo Larrain, Benedicto Chuiaqui, Sergio Puente and
Ricardo C r u z - C o k e w h o have at tended the last
Congresses.
Ricardo Cruz-Coke MD
Director Museo Nacional de Medicina
40
Notices,Vesalius, IX , 2 /41,2003
Notices
N O T I C E I
Le Docteur Alain Ségal, vice président de la SIHM et à l'époque, co-rédacteur pour la langue française, dégage toute responsibilité pour les erreurs typographiques et les fautes de français contenues dans le volumeVIII no. 2 de Vesalius. Il n'a en effet jamais été sollicité pour la relecture des épreuves si bien que les corrections nécessaires n'ont pu être introduites.
N O T I C E 2
T H E W O R S H I P F U L SOCIETY OF APOTHECARIES OF L O N D O N T H E ROYAL COLLEGE OF GENERAL PRACTIT IONERS
T H E ROSE PRIZE
This prize commemorates William Rose, Apothecary of London, whose court case of 1701 -04 established the legal foundation of General Practice in England and Fraser Rose, a co-founder of the Royal College of General Practitioners. The Worshipful Society of Apothecaries of London and the Royal College of General Practitioners are pleased to announce that the Rose Prize for original work in the History of British General Practice will be awarded for the first time in Spring 2005.
Submissions are invited from all non-professional historians either as individuals or as a group who are, or who have been, involved in primary health care. The work should be original and previously unpublished, with demonstrable emphasis on primary source material, and it should have been undertaken in the previous two years. It should also be appropriately illustrated. Any topic on the History of British General practice may be
chosen. Typescript entries should not exceed 8000 words, but submissions in other media will be accepted provided they are of comparable intellectual rigour. Publication will be encouraged.
The winner(s) will have their name(s) engraved on the plinth of the Rose Bowl, which they will keep for two years, and they will also receive a suitably inscribed certificate.
The award will be presented at either Apothecaries' Hall or The College and the winner(s) will be expected to give a short presentation of their work.
For further details and entry forms contact: Ms Kate Messent Awards Administrator The Royal College of General Practitioners 14 Princes gate London SW7 I PU Tel: 020 7581 3232 email: [email protected]
N O T I C E 3
We have received and are glad to publish this notice of an award from the Washington Academy of Science to Alain Touwaide who has recently been elected as a Councillor of the ISHM.
"In order to recognise scientific work of merit and distinction, the Washington Academy of Science gives awards annually to scientists who work in the greater Washington DC area. The history of the awards program, begun in 1940 is literally a catalog of over 60 years of scientific achievement.While we have honoured these scientists over the decades, we have equally been honored by our association with them.
Alain Touwaide received the award for Behavioural and Social Science for his contribution in the history of medicine, particularly pharmacology. A PhD in Classics of the University of Louvain (Belgium 1981) with an Habilitation in History of the University of Toulouse (France 1997), he has been doing inter-disciplinary
research on the history of botany and the therapeutic use of plants in ancient and medieval Mediterranean culture for more than 25 years. Currently a Research Associate at the Smithsonian Institution (National Museum of Natural History), he has published and lectured as extensively as he has travelled in Europe and the Americas in search of ancient material documenting the history of botany. He has been awarded many grants and prizes, and is widely recognised as an expert of ancient therapeutics, especially medicinal plants. He is currently preparing a major reference work on plants in ancient Greece and Rome (A Flora of Classical Antiquity)
Elected a Fellow of the International Academy of the History of Pharmacy (1991) and a Fellow of the Linnaean Society of London (1997),Touwaide becomes ipso facto a Fellow of the Washington Academy of Sciences."
41
Book Reviews,Vesalius, IX , 2,42-44, 2003
Book Reviews
History of Medicine in Alexandria by Dr MA Shehata (2000, in Arabic)
This book was written with the support of the Egyptian Medical Syndicate (Alexandria branch). The author is a Professor of ENT at the College of Medicine - University of Alexandria; he has extensive experience in teaching and interest in the History of Medicine. The 232-page book encompasses 3 parts: history of Alexandria city, history of Medicine in Alexandria, and current Medical practice in Alexandria.
The first part provides a fascinating account of Alexandria, after being transformed from a village called Rachotis prior to Alexander's invasion in 332 BC. The Greek engineer Dinocrates designed and built the city on the order of Alexander the Great, to be his capital of Egypt and a main nerve centre of his Greek Empire.
The second part on the history of Medicine in Alexandria documents the names of Greek doctors followed by Roman doctors practising in Alexandria prior to the Islamic conquest. It then describes Arab doctors and their achievements throughout the Islamic periods of Egypt from Abbasids to Fatimis, Ayyobis, Mamlukis, Ottomans (including the intervening French campaign) and during the Mohammad Ali Pasha family period, as well as the period of President Naser.
The last part on current medical practice lists various colleges of Medicine, Dentistry, Nursing, as well as hospitals, health institutes, medical libraries, drug companies and medical syndicates and associations.The book finishes on an interesting note with a comparison of the Arabic medical services of Alexandria to those of its French counter-city of Marseilles. The former has I 1771 hospital beds and 13376 doctors, serving a population of nearly 4 millions, providing one bed per 250 citizens; while the latter has 4139 hospital beds and 4430 doctors, serving a population of nearly 2 millions, thus providing many fewer beds for its citizens.
By and large, Dr Shehata's book is a nice piece of research in medical history; it certainly makes an interesting account of medical progress in the city of Alexandria throughout history. However, the book can be improved along a few lines. An index of content must be added; a geographical map of Alexandria illustrating its administrative territories inserted; and a more emphatic emphasis on Arabo-lslamic history - there was for example no mention of the famous doctor Abdul Latif Al-Baghdadi who wrote extensively and examined dead bodies during the famine in Egypt. In current Medical Practice, why was there only a photograph of Naser included without further photographs to document Sadat's and Mubarak's periods? In the comparative statistics with Marseilles, perhaps the quality of medical and nursing services need to be emphasised in terms of clinical outcome and patient satisfaction.The book may better be supplemented by an English translation. It is unfortunate that such a book has no ISBN coding, so that it can be standardised and shared by other doctors.
M A RAI-Fallouji, PhD (London), FRCS Consultant and Professor of Surgery (retired)
'Events, Wonders and Anecdotes in History of Medicine throughout various periods9
by Dr MA Shehata (1997, in Arabic)
This 201-page book, also by Dr Shehata, encompasses 15 chapters detailing interesting events retrieved from Egyptian, Babylonian, Chinese, Roman, Greek, Pre-lslamic and Islamic Arabic, European and current Egyptian periods. It also includes anecdotes from divine monotheistic religions: Judaism, Christianity, and Islam.
The book provides a fascinating account of light-hearted anecdotes and uplifting stories collated from a mishmash of sources with selective photos and line-diagrams welded together to entertain the reader about the wonderful aspects in the history of Medicine.The book may even serve as interesting reading for non-medical readers too, and as a nice companion for holidaymakers visiting historical sites.
The book can be improved. The long title can be reduced to a better informative title:'Anecdotes in History of Medicine.'The book's contents can further be revised and reduced in number without reducing its size.The religious events can easily be incorporated within the appropriate historical periods e.g. Prophetic Medicine and events within Islamic Arabic Medicine.The book, in its current style, is targeted to Arabic readers. Again, it is unfortunate that such a good book has no ISBN coding, so that it can be standardised and shared by other doctors.
MAR Al-Fallouji, PhD (London), FRCS Consultant and Professor of Surgery (retired)
42
Book Reviews,Vesalius, IX , 2,42-44, 2003
The Life of Sir John Forbes (1787-1861) by Dr RAL Agnew
Published 2002 by Bernard Durnford Publishing,Tudor Cottage, 457 Upper Shoreham Road, Shoreham-By-Sea,West Sussex, BN43 5WG England, UK (81 pp. Available from the publisher £4.99 inc. p and p)
This little book describes the life and career of John Forbes, a Scot who studied Medicine in Edinburgh and worked for most of his professional life in England.
After service in the Napoleonic wars, he received an Edinburgh MD, written on the subject of the happiness to be gained from mental pursuits.
In 1821, he translated Laennec's work on Auscultation into English. Although he made a number of changes to the original French text, including re-arranging and shortening it and altering the terminology of Laennec's description of the sounds heard, his version ran to four editions and undoubtedly helped to make the work more widely available.
In 1832, with John Conolly and Alexander Tweedie, he produced the 'Cyclopaedia of Practical Medicine' which appeared monthly until 1835 and he followed this in 1836 with the'British and Foreign Medical Review or Quarterly Journal of Practical Medicine and Surgery'This quickly built a reputation on the quality of the articles selected and it was read throughout Europe and America, helping to spread news of modern medicine.
DrAgnew's book covers these achievements and other aspects of Forbes' life. Although modest in size, the book is comprehensively referenced and gives a picture of a nineteenth century physician with broad interests.
David Wright
SCOTLAND'S HEALTH 1919-1948 Jacqueline Jenkinson
Peter Laing, Bern, 2002 506 pages ; 5 plates ; 1124 references ; ISBN 3-906768-34-1 ; price £42
In 1919, a Ministry of Health was established in London to 'co-ordinate and develop measures for the health of the people throughout England and Wales.1 The new Ministry was formed on the model long established in Whitehall in which the responsible Minister is supported by a hierarchical structure of civil servants, headed by a powerful and influential Permanent Secretary. In the years between the wars, this single Ministry maintained a uniform supervision of the health of all the disparate people from the relatively prosperous south-east to the remote rural south west, from the deprived South Wales to the depressed industrial northeast — some thirty five million people living in very different social circumstances.
No such Ministry was created for Scotland. By 1919, Scotland already had the Highlands and Islands Medical Board, successfully administering a comprehensive state medical service in the remote rural north-west. In 1919 a Board of Health was set up, not of civil servants but of members of the public, to oversee and develop services for a Scottish population of less than five million, that - the Highlands and Islands apart - was overwhelmingly industrialised, urban, badly housed and poor. From 1919, Scotland had an effective degree of autonomy in the management of its state medical services and an administration organised to cater for two distinct populations, each with its own characteristic and clearly recognised set of needs. Whether or not this autonomy and more focused administration acted to Scotland's advantage is a question that has not attracted the attention of medical historians.
Now, Jacqueline Jenkinson makes a welcome beginning — although her title, Scotland's Health, is somewhat misleading. Her very careful study focuses only on the Scottish administration of the new 'personal' health services introduced in Britain between the wars and the impact of these services on the health trends of the Scottish population. The services studied are those concerned with infant and child welfare, the treatment of tuberculosis, school health provision and the health of the insured population.
The author presents a full account of all the legislation relating to these services in a degree of detail that will satisfy the most demanding but may well prove forbidding to the more general reader. Similarly, the author supports her conclusions on the effectiveness of these new services with a wealth of excellent statistics, but then goes on to include evidence that many will find of very uncertain value.The author's exposition is further complicated by fact that there
43
Book Reviews,Vesalius, IX , 2,42-44, 2003
is no simple direct causal relationship between the introduction of these new services and subsequent changes in the health of the target population. Here, the influence of other variables such as housing standards, overcrowding, unemployment patterns and poverty are all very properly taken into account. The result is a very complicated story; unfortunately the author's style does not make for an easy read and her conclusions are not as decisive as we might hope.
This is an earnest, erudite and valuable contribution to a subject that has not attracted the attention that it deserves.The work has now begun and Jacqueline Jenkinson is to be congratulated.
I The Times, 10 January 1918. Morrice McCrae
44
Letter to the Editor,Vesalius, IX , 2 ,45,2003
Letter to the Editor
Ass Prof.A.Diamandopoulos, Romanaou Vilage, Patras,
Greece 26 500 e-mail [email protected]
Dear Editor, I received the last issue ofVesalius, and appreciated the
work put in it, both in content and in editing and printing. However, believing that a lively correspondence via your pages will only make the Journal more interesting, I submit a few comments on an excellent article published in this last issue. It is titled Poetical Allusions to the Circulation of Blood up to the end of the Seventeenth Century, by Dr J.R.Young. I enjoyed the well-presented material and the personal style. My contribution aims only to enrich the supplied information.
The article, although rightly stating that the examination of poetry gives a measure of the diffusion of medical knowledge into the laity, then proceeds to present many examples of English poetry on medical themes, mainly on Harvey's theory of circulation. Thus, while entirely covering its subject as described in the title, it doesn't delineate its importance in time and space. Medical poetry had started many centuries before Harvey and continues today. The most ancient example is allegedly The Book of Instructions, written by Pharaoh Althoth circa 3,000 BC, containing verses on all then known medical knowledge. Circa 1,500 BC the huge Indian medical poems Charaka Samhita pertaining to internal medicine, and Sushruta Samhita pertaining to surgery, were written.
Trying to keep this letter brief, I skip the numerous examples from Classic Antiquity and present a few medieval poetical works from the Latin West or the Greek and Islamic East. From the former we have the poetical form of the Questions of Salerno as written in Latin hexameters by Urso in the I 3th century. From the same region and roughly the same period, comes the medical poem of Aegidius Corboliensis (Gill de Corbeil) Carmina de judiciis urinarum. From the Greek East let us recall only two Byzantine poems. The first is the excellent Medical Work in iambic metres (Llovinua IcupiKov apicrTov 8i ' Ia|xP(ov) by the prominent Constantinopolitan politician, philosopher, courtier, monk, and medical doctor Michael Psellus in the I Ith century.
The second is the 13th or 14th century medical work « On urines by the wisest Blemmydes » (Ilepi Chipcov ITTTO TOU 2oi|ja)TaTou BXeu uiiScw) which was written in verse and was accompanied by ecclesiastical music. As a token gesture to the vast Islamic literature, Avicenna's
« Poem on Medicine » (al'Arzurrat fi-t tibb) of the I Ith century, is mentioned. Literary descendants of the medieval medical poems abound and a good collection is housed in the Library of the Wellcome Institute in London. Closer to Harvey's era we find the musical and poetical work by Martin Marais composed in 1720 under the title The Scene of Lithotomy (Le tableau de I'operation de la taile) and still later a 20th century poem by an anonymous wri ter published in St Bartholomew's Hospital Journal, relating to the recognition of proteinuria as the cause of the nephrotic syndrome by Richard Bright.
All the above-cited works form just a negligible percentage of the documented medical poems. But even so, it becomes evident that the Poetical Allusions to the circulation of Blood up to the end of the Seventeenth Century are but a small link to a huge chain of this literary genre that can be traced in any historical period and in every part of the world. I hope that the aforementioned comments by the writer of the present article, who comes from 'Foreign Coasts' will be welcome, in spite of his place of origin. After all, his ancestral home is in the Heleia Province of Greece, just three kilometres away from the legendary Augean Filths.
Yours sincerely, A.A. Diamandopoulos,
Nephrologist- Archeologist
45
Medical History Conferences and Meetings,Vesalius, IX , 2,46, 2003
Medical History Conferences and Meetings 2004-2005
Conference
Italy - Bari. 39th ISHM Congress
Greece — Delphi Symposium on the History of Diabetes
Date
5-10th September, 2004.
7-9 September, 2005.
Contact/web site
Professor Alfredo Musajo-Somma www.39ishmcongress2004.lt
[email protected] [email protected]
46
Vesalius , IX , 2, 47,2003
International Society for the History of Medicine
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47
Vesalius, IX , 2,47-48, 2003
Société Internationale d'Histoire de la Médecine
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48
Vesalius - Acta Internationalia Historiae Medicinae
Table of Contents
19
22
25
31
35
41
42
45
46
47
Editorial David W r i g h t Philippe A lbou
Le site Internet de la Bibliotheque Inter-universitaire de Medecine (BIUM) de Paris Philippe A lbou and Christ ian Regnier
The sooterkin dissected: the theoretical basis of animal births to human mothers in early modern Europe A . W . Bates
Stuttering in antiquity - Moses and Demosthenes Assi Cicurel and Shifra Shvarts
Langerhans in the Middle East: More about the discoverer of the pancreatic islets Efraim Lev, Karin Ohry-Kossoy and Avi O h r y
The 'Batavia,' an apothecary, his mutiny and its vengeance James H. Leavesley
Louis XIV et le quinquina Stan is Perez
Cartesianisme et circulation sanguine Jean Jacques Peumery
Reports of Congresses and News from Member Countries:
Reading 2003 A n n Ferguson
Mexico, 17-20 septembre 2003 Andres A r a n d a and D iana Gasparon
News from Finland Hindr ik S t randberg and Juhani Karja
The USSR (1959-1986) Vasylyev G. Kostyantyn
Italy 2003 J. S . G . B l a i r
News from Chile Ricardo C r u z - C o k e
Notices
Book Reviews History of Medicine in Alexandria Dr M .A . Shehata
Events, Wonders and Anecdotes in History of Medicine throughout various periods Dr M . Shehata
The Life of Sir John Forbes (1787-1861) Dr R.A. L .Agnew
Scotland's Health 1919-1948 Jacqueline Jenkinson
Letter to the Editor
Medical History Conferences and Meetings
Applications for membership
Vol. IX, No 2 December, 2003